胃电刺激模拟胃窦异位起搏点引发犬远端胃电紊乱的研究  

RETROGRADE ELECTRICAL STIMULATION WITH HIGH FREQUENCY LONG PULSES USING A MINIMUM ENERGY INDUCE ANTRAL GASTRIC DYSRHYTHMIAS WITHOUT NOTICEABLE DYSPEPTIC SYMPTOMS IN DOGS

作　　者：杨杰[1] 张侃[2] 余晓云[2] 侯晓华[2] 

机构地区：[1]贵阳医学院附属医院消化科,贵州省贵阳市550004 [2]武汉协和医院消化科

出　　处：《中国煤炭工业医学杂志》2008年第9期1439-1442,共4页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨高频长脉冲逆行胃电刺激(retrograde gastric electrical sti mulation,RGES)诱导远端胃电紊乱的最低能量。方法在7条比格犬的胃大弯前壁浆膜层植入4对心脏起搏电极。通过最远端电极输入不同振幅的高频长脉冲胃电刺激模拟异位起搏,诱导远端胃电紊乱,从而获得最低电刺激能量。观察电刺激前、刺激中和刺激后消化不良症状并进行评分。结果①最低能量为(85.71±11.34)(mA.ms)的高频长脉冲RGES可以影响远端胃慢波,而且刺激前后消化不良评分无明显差异;②RGES使远端胃正常胃慢波百分率降低[(92.48±10.57)%vs(25.25±17.08)%,P=0.001],胃电过速百分率升高[(0.61±1.05)%vs(55.37±25.05)%,P=0.001)。结论低能量高频长脉冲RGES可作为人工模拟胃窦异位起搏点的方式之一,其能诱发远端胃快速性胃电紊乱,且无可见的消化不良症状。Objective To investigate the capability of a minimum energy of retrograde gastric electrical stimulation （RGES） with high frequency long pulses inducing dysrhythmia in canine distal stomach. Methods Seven female beagles chronically implanted with four pairs of cardiac pacing electrodes on gastric serosa were applied with high frequency long pulses via a pair of electrode leads at 2cm proximal to pylorus. Long pulses included a series of stimulation parameters： fixed pulse frequency （gycle/min）, fixed pulse width （300ms） and different settings of pulse amplitude with up - regulation from 0. lmA stepwise until appearance of dysrhythmia in distal stomach. And the occurrence of dyspeptic symptoms during the period of 10min RGES with minimum, 30min before or after 10- min RGES was scored, respectively. Gastric slow wave at 30min baseline and during different settings of stimulation were recorded. Results Minimum stimulation energy for high frequency long pulses RGES to produce dysrhythmias in the distal stomach was 85.71 ± 11.34 （ms·mA）. RGES with minimum energy decreased the normal gastric slow wave from 92. 48% ± 10.57% to 25.25% ± 17.08% and increased the tachygastria from 0.61% ± 1. 055% to 55.37% ± 25.05%. And the scores for dyspeptic symptoms before RGES were no significantly different than those both after RGES and during RGES. Conclusion Low energy - long pulse RGES at high frequency can be either one of ways to mimic artifical ectopic pacemaker in gastric antrum or induce predominant tachygastria in the distal stomach without noticeable dyspeptic symptoms.

关 键 词：逆行胃电刺激 胃慢波 消化不良 临床分析 

分 类 号：R657.34[医药卫生—外科学] R570.5[医药卫生—临床医学]