血管活性肠肽介导人食管下括约肌舒张的实验研究

Role of Vasoactive Intestinal Peptide in Relaxation of the Lower Esophageal Sphincter in Human

目的研究血管活性肠肽(VIP)对人食管下括约肌(LES)套索纤维和钩状纤维的作用及其差异,探索VIP是否属于非肾上腺非胆碱能(NANC)神经递质。方法选取2010年3～8月在河北医科大学第四医院因高位食管中段癌行食管大部切除术患者30例,其中男14例,女16例;年龄(58.0±6.1)岁。选LES标本,分离钩状纤维和套索纤维,做外源性VIP对套索纤维和钩状纤维的浓度效应曲线,比较分别在电场刺激(EFS)和外源性VIP作用下,VIP(10-28)对LES的不同影响。结果在LES离体实验条件下,外源性VIP在不同浓度下可使套索纤维和钩状纤维产生浓度依赖性舒张反应,在相同VIP浓度下套索纤维和钩状纤维舒张变化的差异有统计学意义(P<0.05),套索纤维的舒张作用大于钩状纤维。VIP(10-28)能够短暂一过性抑制外源性VIP的作用。VIP(10-28)对EFS作用后的套索纤维和钩状纤维均产生了短暂一过性的抑制作用。结论 EFS诱导钩状纤维和套索纤维的舒张与VIP有关,实验结果支持VIP是人LES内NANC神经递质之一。

Objective To investigate the influence of vasoactive intestinal peptide（VIP） on the sling fibers and the clasp fibers of the lower esophageal sphincter（LES） and the difference,and explore whether VIP belongs to a nonadrenergic and noncholinergic（NANC） neurotransmitter.Methods Thirty LES specimens were obtained from 30 patients with high-position carcinoma of the middle thoracic esophagus who underwent esophagectomy from March to August 2010 in Fourth Affiliated Hospital of Hebei Medical University.There were 14 male patients and 16 female patients with their average age of 58.0±6.1 years.The clasp fibers and sling fibers were isolated and suspended in perfusion.Exogenous VIP was added to the two kinds of strips to draw a concentration-effect curve.Electric field stimulation（EFS） or exogenous VIP was applied to clasp fibers and sling fibers,and the influence of VIP（10-28） on LES was compared.Results Exogenous VIP in different concentration caused concentration-dependent relaxation of the sling fibers and clasp fibers of LES in vitro. There was statistical difference in relaxation between the sling fibers and clasp fibers under same VIP concentration（P0.05）, and the relaxation of sling fibers was more significant than that of clasp fibers.VIP（10-28） transiently inhibited the relaxation of the sling fibers and clasp fibers caused by exogenous VIP.VIP（10-28） also transiently inhibited the relaxation of the sling fibers and clasp fibers after the activation of EFS.Conclusion The relaxation of sling fibers and clasp fibers induced by EFS is related to VIP.VIP is a kind of NANC neurotransmitter in human LES.