胃壁张力决定胃扩张的感知。

Gastric wall tension determines perception of gastric distention.

作者信息

Distrutti E, Azpiroz F, Soldevilla A, Malagelada J R

机构信息

Digestive System Research Unit, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.

出版信息

Gastroenterology. 1999 May;116(5):1035-42. doi: 10.1016/s0016-5085(99)70006-5.

DOI:10.1016/s0016-5085(99)70006-5

PMID:10220495

Abstract

BACKGROUND & AIMS: The primary mechanism that originates symptoms in response to gastric distention remains undefined. The aim of this study was to determine which factor, whether intragastric volume, pressure, or wall tension, determines perception of gastric distention.

METHODS

Healthy subjects underwent increasing gastric distentions (2-minute duration at 5-minute intervals) either at fixed pressure levels using a conventional barostat (n = 10) or at fixed tension levels using a newly developed computerized tensostat (n = 12); perception was scored by a 0-6 scale. Distentions were performed during basal conditions (intravenous saline) and during gastric relaxation by glucagon administration (4.8 microgram/kg intravenous bolus plus 9.6 microgram. kg-1. h-1 infusion).

RESULTS

Isobaric distentions with the conventional barostat produced more intense perception during glucagon (95% +/- 40% higher; P < 0.05). However, the factor that determined higher perception could not be ascertained, because at the same pressure levels both intragastric volume and wall tension were greater during glucagon administration (174% +/- 56% and 34% +/- 8% greater, respectively; P < 0.05 vs. saline for both). The tensostat evidenced that perception was selectively related to tension, not to elongation; during glucagon administration, intragastric volumes were significantly larger (80% +/- 28% larger increase; P < 0.05), but perception of isotonic distentions remained the same (27% +/- 22%; nonsignificant change).

CONCLUSIONS

Gastric wall tension, but not intragastric volume, determines perception of gastric distention, at least below nociception.

摘要

背景与目的

胃扩张引起症状的主要机制尚不清楚。本研究旨在确定是胃内体积、压力还是壁张力这一因素决定了对胃扩张的感知。

方法

健康受试者使用传统恒压器在固定压力水平下（n = 10）或使用新开发的计算机化张力计在固定张力水平下（n = 12）进行递增的胃扩张（每次持续2分钟，间隔5分钟）；感知通过0 - 6分制评分。在基础状态（静脉输注生理盐水）和通过注射胰高血糖素使胃松弛期间（静脉推注4.8微克/千克，随后以9.6微克·千克⁻¹·小时⁻¹输注）进行扩张。

结果

使用传统恒压器进行等压扩张时，在注射胰高血糖素期间产生的感知更强烈（高95% ± 40%；P < 0.05）。然而，由于在相同压力水平下，注射胰高血糖素期间胃内体积和壁张力均更大（分别大174% ± 56%和34% ± 8%；与生理盐水相比均P < 0.05），所以无法确定导致更高感知的因素。张力计显示，感知与张力而非伸长选择性相关；在注射胰高血糖素期间，胃内体积显著更大（增加80% ± 28%；P < 0.05），但等张扩张的感知保持不变（27% ± 22%；无显著变化）。