多种胃肠激素在消化间期移行性复合运动中作用的研究

Effects of multiple gut hormones on human interdigestive migrating motor complex

目的 通过研究胃肠激素与消化间期移行性复合运动(MMC)的关系,探讨 MMC发生及其调节机制。方法 应用胃十二指肠测压技术对30例健康志愿者的消化间期胃十二指肠运动的特征进行研究,并在检测过程中分别于MMCⅠ、Ⅱ和Ⅲ相采集静脉血行胃动素(MTL)、生长抑素(SS)、P物质(SP)及一氧化氮(NO)的血浆浓度检测。结果 MMC周期为112.7 min±37.2 min,MMCⅠ相最长,Ⅱ相次之、Ⅲ相最短,MMCⅢ相多起源于胃窦,也可起源于十二指肠。MMC多向远端移行,偶见逆向传导。MMCⅢ相血浆MTL为921.7 pg/ml±109.8 pg/ml,SP为10.9 pg/ml±7.2 pg/ml,明显多于Ⅰ相(分别为334.7 pg/ml±58.1 pg/ml,11.3 pg/ml±8.8 pg/ml)和Ⅱ相(分别为 370.0 pg/ml±69.2 pg/ml,11.0 pg/ml±10.0 pg/ml),差异有统计学意义(P<0.05)。血浆 SS、NO水平各时相相比差异无统计学意义(P>0.05)。结论 MTL、SP可能与 MMCⅢ相的诱发有关。血浆 SS、NO水平可能对胃肠MMC无直接作用。

Objective To investigate the relationship between interdigestive migrating motor (complex) (MMC) and gut hormone and to explore the mechanism of the generation and regulation of MMC. Methods The MMC cycles were investigated by gastrointestinal manometry in 30 healthy volunteers. Plasma concentrations of motilin (MTL), somatostatin (SS), substance P(SP) and nitric oxide (NO) were determined by radioimmunoassay during the three phases of MMC. Results The duration of MMC cycle length was 112.7 min±37.2 min. Phase Ⅰ was the longest, and phase Ⅲ was the shortest. MMC cycles were originated from antrum or duodenum, most of them were originated from antrum. Phase Ⅲ often migrated from antrum to duodenum. Occasionally it showed a retrograde pattern. Phase Ⅲ was concurrent with the peak level of plasma MTL((921.7 pg/ml)±109.8 pg/ml) and SP (10.9 pg/ml±7.2 pg/ml) levels compared with phase Ⅰ(334.7 pg/ml±58.1 pg/ml,11.3 pg/ml±8.8 pg/ml) and phase Ⅱ(370.0 pg/ml±69.2 pg/ml,11.0 pg/ml±10.0 pg/ml). There were no significant differences of (plasma) SS and NO concentrations among the three phases of MMC. Conclusions MTL and SS might be (necessary) for the generation of phase Ⅲ. Plasma concentrations of SS and NO might not have direct effect on the cycle of MMC.