胃起搏前后胃瘫犬胃排空和血浆胃动素的关系  

The relation of gastric emptying and plasm motilin level before and after gastric pacing in a canine model of gastroparesis

作　　者：杨敏[1] 房殿春[1] 龙庆林[1] 隋建峰[2] 李前伟[3] 

机构地区：[1]第三军医大学西南医院全军消化专科中心,重庆400038 [2]第三军医大学生理教研室,重庆400038 [3]第三军医大学西南医院同位素科,重庆400038

出　　处：《重庆医学》2003年第9期1152-1154,共3页Chongqing medicine

摘　　要：目的　探索胃起搏对胃瘫犬胃排空和血浆胃动素的影响 ,及起搏治疗前后胃排空与血浆胃动素浓度的关系。方法　采用双侧迷走神经干切断术联合应用胰高血糖素建立胃瘫犬模型 ;采用放射性核素99mTc 植酸钠标记的半固体试餐 ,计算机断层摄影显像技术 (SPECT)检测术前、术后及起搏治疗后的胃半排时间 (GEt1/ 2 ) ,同期应用放免法 (RIA)测定血浆胃动素 (MTL)含量 ;采用适宜的起搏参数从胃体、胃窦在腹部体表的投影部位输入起搏信号 ,驱动胃电节律。结果　模型犬术后的GEt1/ 2 (79.4 2± 1.91)min较术前 (5 6 .35± 2 .99)min ,P <0 .0 0 1明显延迟 ,血浆MTL含量 (2 4 2 .0 9± 17.2 2 ) pg/ml显著高于术前 (184 .2 9± 9.81) pg/ml,P <0 .0 1,且胃排空与MTL呈负相关 ;但行胃起搏治疗后 ,模型犬的GEt1/ 2 (6 4 .94± 1.75 )min ,P <0 .0 0 1和血浆MTL含量 (2 12 .5 5± 11.2 0 )pg/ml,P <0 .0 2明显低于治疗前 ,且胃排空与MTL呈正相关。 结论　胃起搏可加速胃排空 ,恢复或改变胃肠功能活动 ;胃起搏前后 ,血浆MTL含量与胃排空有相关性 。Objective To investigate the effect of gastric pacing on gastric emptying and plasm motilin concentration in a canine model of gastroparesis, and to explore if there existe a correlation between gastric emptying and plasm motilin level before and after pacing. Methods A model of gastroparesis was established by truncal vagotomy combined with injection of glucagon;gastric half emptying time (GE t1/2 ) in preoperative and postoperative and post treatment states was monitored and analysed using single photon emission computerized tomography (SPECT ), and the half solid test meal was labeled with an isotope 99m Tc sulfur colloid, and synchronously plasm motilin (MTL) levels were estimated by radioimmunoassay (RIA) technique;surface gastric pacing using the optimal pacing parameters was applied to entrain gastric slow wave. Results Compared with those before surgery, GE t1/2 of model dogs with vagotomy increased significantly from 56.35 ± 2.99 min to 79.42±1.91 min ( P <0.001), and MTL concentration raised obviously from 184.29 ± 9.81 pg/ml to 242.09±17.22 pg/ml ( P <0.01), and gastric emptying and MTL level existed negative correlation . After surface gastric pacing, GE t1/2 (64.94±1.75 min, P <0.001)and MTL level(212.55 ± 11.20 pg/ml, P <0.02)of model dogs was reduced significantly in comparison with pretreatment, and gastric emptying and MTL level showed positive correlation. Conclusions Surface gastric pacing significantly accelerated gastric emptying and resumed or altered motor function. Gastric emptying correlated well with plasm MTL level before and after pacing,and MTL could participate the mechanism process of gastric pacing.

关 键 词：胃排空 胃动素 胃起搏 胃瘫 迷走神经干切断术 胰高血糖素 

分 类 号：R57[医药卫生—消化系统]