探讨胃动素、神经降压素和一氧化氮合酶与Oddi括约肌运动功能障碍的关系  

Impact of motilin, neurotensin and nitric oxide synthase on sphincter of Oddi dysfunction

作　　者：庞雪莹 任旭[2] 夏添[2] 梁金龙[2] 王晨[2] 唐秀芬[2] 孙晓梅[2] 

机构地区：[1]黑龙江中医药大学附属第一医院肿瘤科,哈尔滨150040 [2]黑龙江省医院消化病院

出　　处：《中华消化内镜杂志》2017年第12期892-896,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨胃动素（MTL）、神经降压素（NT）及一氧化氮合酶（NOS）对胆囊切除后Oddi括约肌（s0）运动功能的影响。方法在动物实验中，豚鼠造模组（胆囊切除）和对照组（开关术）术后12周行SO压力测定（SOM），计算受试者工作特征（ROC）曲线下面积值（AUC）及界限值，从造模组中筛选出符合条件的豚鼠，作为s0运动功能障碍（SOD）模型组。采用放射免疫法检测SOD模型组和对照组血浆MTL、NT的含量及采用积分光密度值方法检测SO组织中MTL、NT及NOS蛋白表达量。在临床研究中，比较SOD组（s0压力〉40mmHg）和对照组患者血浆MTL、NT含量。结果根据ROC曲线计算AUC为0．75，豚鼠s0压力≥29．8mmHg（界限值）为SOD模型组。SOD模型组（n=10）血浆MTL[（193．16±29．2）pg／mL]和NT含量[（104．57±19．52）pg／mL]均分别高于对照组（n=11）血浆MTL[（154．24±27．69）pg／mL]和血浆NT含量[（79．65±11．24）pg／mL]（P〈0．01）；SO中MTL（3556．71±455．80）和NT蛋白表达量（6321．74±203．54）高于对照组MTL（3075．92±350．06）和NT蛋白表达量（5843．57±344．00），而NOS蛋白表达量（2954．21±173．54）低于对照组（3314．91±246．67）（P〈0．05）。临床研究SOD组（n=15）血浆MTL[（350．98±24．31）pg／mL]和NT含量[（102．39±19．56）pg／mL]分别高于对照组（n=15）MTL[（319．56±23．54）pg／mL]和NT含量[（80．45±12．35）pg／mL]（P〈0．05）。结论血浆MTL和NT含量以及s0中MTL、NT和NOS蛋白表达量与SOD发生有关。检测血浆MTL和NT可能对胆囊切除术后SOD有辅助诊断作用。Objective To investigate the impact of motilin （MTL）, neurotensin （NT） and nitric oxide synthase （NOS） on Oddi sphincter （SO） motion after cholecystectomy. Methods Oddi sphincter manometry （SOM） was performed on both Guinea pig model group （cholecystectomy） and control group （laparotomy） 12 weeks after operation. Sphincter of Oddi dysfunction （SOD） group was determined by receiver operating characteristic（ROC） curve analysis and area under curve （AUC）. Protein expression of MTL, NT and NOS in SO was also detected through integral optical density method. Meanwhile, the contents of MTL and NT in patients＇ plasma of both SOD group （ SO pressure〉 40 mmHg） and control group were compared. Results AUC of 0.75 and SO pressure of more than 29.8 mmHg was determined as the standard of SOD group. MTL and NT contents （ 193.16±29.2 pg/mL and 104. 57±19. 52 pg/mL, respectively） of the model group （n= 10） in plasma were significant higher than those of control group （n = 11 ） （ 154. 24± 27.69 pg/mL and 79.65±11.24 pg/mL, respectively）, and same trend of MTL and NT protein expression in SO was detected （3 556. 71±455.80 and 6 321.74±203.54 of the model group; 3 075.92±350. 06 and 5 843.57±344. 00 of the control group）. While NOS protein expression in model group was lower than that of the control group （ 2 954. 21± 173.54 VS 3 314. 91 ±246. 67, P 〈 0.05 ）. In clinical research, the plasma contents of MTL（ 350. 98±24. 31 pg/mL VS 319. 56±23.54 pg/mL） and NT（ 102. 39± 19.56 pg/mL VS 80. 45±12. 35 pg/mL） in SOD group （n= 15） were higher than those of the control group （n= 15） （P〈 0. 05）. Conclusion MTL and NT contents in plasma and protein expression of MTL, NT and NOS in SO may be related to SOD. MTL and NT examinations may assist diagnosing SOD after cholecystectomy.

关 键 词：Oddi括约肌运动功能障碍 胃动素 神经降压素 一氧化氮合酶 括约肌压力测定 

分 类 号：R657.4[医药卫生—外科学]