胃起搏对胃动力紊乱犬胃排空及胃肌电活动的影响  

Effects of gastric pacing on gastric emptying and gastric myoelectrical activity in a canine model of gastric motor disorders

作　　者：杨敏[1] 房殿春[1] 龙庆林[1] 隋建峰[2] 李前伟[3] 孙念绪[4] 甘露[4] 

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 [3]第三军医大学西南医院同位素科,重庆400038 [4]第三军医大学西南医院普外科,重庆400038

出　　处：《中华消化杂志》2003年第5期267-270,共4页Chinese Journal of Digestion

摘　　要：目的　研究胃起搏对胃动力紊乱犬胃排空及胃电参数的影响。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动力紊乱犬模型 ;采用 4导联胃肠电系统微机分析仪记录胃肠浆膜肌电活动 ;99mTc 植酸钠标记的半固体试餐 ,单光子计算机断层显像技术 (SPECT)检测胃半排空时间(GEt1/ 2 ) ;采用适宜起搏参数从胃体、胃窦在腹部投影部位输入起搏信号驱动胃电节律。结果　迷走神经干切断术后犬的GEt1/ 2 为 (79.4 2± 1.91)min ,较术前 (5 6 .35± 2 .99)min明显延迟 (P <0 .0 0 1) ,但行胃起搏治疗后GEt1/ 2 为 (6 4 .94± 1.75 )min ,较治疗前明显加快 (P <0 .0 0 1) ;胃起搏治疗前迷走神经干切断犬餐后的胃电频率为 (0 .0 81± 0 .0 0 7)Hz、胃电幅度为 (2 .32± 0 .35 )mV、慢波的传播速度为 (4 .0 6± 0 .4 0 )cm/s ,均较正常对照犬显著降低 [(0 .0 90± 0 .0 0 6 )Hz ,(4 .2 5± 0 .12 )mV ,(6 .92± 0 .2 4 )cm/s,(P <0 .0 5 ) ],治疗后其餐后胃电频率 (0 .0 92± 0 .0 0 5 )Hz、胃电幅度 (3.97± 0 .19)mV和慢波的传播速度 (5 .5 7± 0 .4 8)cm/s均明显高于治疗前 (P <0 .0 5 )。结论　采用适宜起搏参数输入起搏信号可完全触发胃电慢波 ,改善胃电参数 ,纠正药物导致的异常胃电节律 ,加速胃排空 。Objective To investigate the effect of gastric pacing on gastric emptying and gastric myoelectrical activity in a canine model of gastric motility disorders. Methods A model of gastric motor disorders was established by truncal vagotomy combined with injections of glucagon; daily gastric serosal myoelectrical activity was recorded using four-channel computer analysis instruments; gastric half-emptying time (GE t 1/2) was monitored and analyzed using single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with isotope- 99mTc sulfur colloid; surface gastric pacing using the optimal pacing parameters was applied for entrance of gastric slow waves. Results Compared with that before the operation, GE t 1/2 of the model dogs with vagotomy increased significantly from (56.35 ±2.99) min to (79.42±1.91) min( P <0.001), but after gastric pacing, GE t 1/2(64.94±1.75) min reduced more markedly than that in the pretreatment( P <0.001). Basic electrical rhythm (BER) frequency ((0.081± 0.007) Hz), amplitude((2.32±0.35) mV) and propagation velocity((4.06±0.40) cm/s)of model dogs in the fed state decreased more significantly than those in the control dogs((0.090±0.006) Hz,(4.25 ±0.12) mV,(6.92±0.24) cm/s, P <0.03), but after gastric pacing treatment, BER frequency((0.092 ±0.005) Hz), amplitude ((3.97±0.19) mV)and propagation velocity((5.57±0.48) cm/s)increased more markedly than those in the pretreatment ( P <0.05). Conclusion Surface gastric pacing using the optimal pacing parameters may trigger gastric slow wave completely and thus improve the parameters of gastric myoelectrical activity and normalize gastric dysrhythmias induced by pharmacological agents. Surface gastric pacing significantly accelerates the gastric emptying and resumes or alters the motor function.

关 键 词：胃起搏 胃动力紊乱 胃排空 胃肌电活动 影响 糖尿病胃轻瘫 胰高血糖素 

分 类 号：R573.9[医药卫生—消化系统]