胃电刺激对顺铂诱导的犬呕吐症状的影响

The effect of gastric electrical stimulation on cisplatin-induced emesis in dogs

目的研究顺铂（cisplatin，DDP）对胃肌电活动的影响，并探讨胃电刺激（GES）对化疗药物引起的犬呕吐和消化不良症状的治疗效应。方法7只比格犬的胃浆膜均被植入4对电极，每只犬均先后进行两阶段实验。（1）DDP阶段：给予DDP（1．5mg／kg），自给药开始持续记录胃电活动及动物症状；（2）GES＋DDP阶段：自DDP给药开始，经近端胃体部电极持续给予串脉冲GES，给药剂量、胃电活动及症状记录同DDP阶段。结果（1）DDP能诱导犬恶心呕吐症状及胃电紊乱：DDP阶段动物均出现频繁呕吐，呕吐次数为（5．5±1．2）次，总症状评分为31．83±2．75。通过胃电记录发现，基线水平时正常胃慢波占（96．50±1．14）％，而呕吐期间正常胃慢波占（69．61±5．81）％（P=0．003），并且胃电过速和胃电过缓发生的百分比均明显高于基线水平（P=0．020和P=0．031）。（2）GES能减轻DDP诱导的呕吐和消化不良症状：GES＋DDP阶段比格犬的症状评分较DDP阶段明显降低（24．50±1．45比31．83±2．75，P=0．028），并且呕吐次数也明显减少（3．7±0．8比5．5±1．2，P=0．028）。但GES对DDP引起的胃电紊乱无明显影响。结论DDP能诱导犬呕吐和胃电紊乱。串脉冲GES能明显减轻DDP引起的呕吐和消化不良症状，但对胃电紊乱无明显影响。

Objective The aims of this study were to investigate the effects of cisplatin （DDP） on gastric myoelectrical activity and the roles of gastric electrical stimulation （GES） in the treatment of druginduced emesis in dogs. Methods Four pairs of electrodes were implanted in gastric serosa in seven female dogs, all dogs performed followed two-session study： intravenous infusion of DDP （1.5 mg/kg） was given for 1 h in DDP-contro] session and DDP-GES session. Trains of short pulses GES was applied on the proximal pair of gastric electrodes from drugs infusion. It lasted 6 h in GES session. Gastric slow waves and animal behaviors were recorded in each session. Results （1）DDP induced nausea and gastric dysrhythmia. The total number of emesis was 5.5 ± 1.2 in DDP-control session, and the total symptom score was 31.83± 2.75. The gastric slow wave showed both bradygastria and tachygastria during the period of emesis （P = 0. 031 and 0. 020 vs baseline）. The percentage of normal slow wave was （69. 61 ± 5.81 ） % during this period （P = 0. 003 vs baseline ）. （2）GES reduced emesis and the animal behavioral score suggestive of nausea compared with DDP-control sessions. The total behavioral score and total number of emesis decreased in this session （ all the P 〈 0. 05 ）. However, GES had no effects on gastric dysrhythmia. Conclusions DDP induced emesis and gastric dysrhythmia. GES with trains of short pulses relieves druginduced emetic responses but has no effects on dysrhythmia.