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胃十二指肠蠕动活动向口侧和向肛侧传播的无创记录(实验与临床研究)

Non-invasive registration of the aboral and oral spreading of the gastroduodenal peristaltic activity (experimental and clinical investigations).

作者信息

Atanassova E, Damianov B, Gurkov P, Kolev V

机构信息

Institute of Physiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.

出版信息

Acta Physiol Pharmacol Bulg. 1998;23(1):15-20.

Abstract

The electrical activity of the stomach and the upper part of the small intestine of healthy volunteers and patients with nausea and vomiting was recorded non-invasively on an original electrogastrograph. Two kinds of waves were distinguished according to their amplitude: low-amplitude waves, corresponding to the period of quiescence of migrating myoelectrical complex (MMC) and about twice higher in amplitude waves, characterising the periods of activity of MMC (peristaltic activity). There was also some difference between the low- and high-amplitude waves from the small intestine. Sequence of high-amplitude waves recorded from the stomach was followed usually by sequence of high-amplitude waves from the small intestine, presenting the aboral spreading of an activity period of MMC from the stomach to the small intestine. In some patients however, high-amplitude waves were led off first from the duodenal record and after that high-amplitude waves appeared in the gastric record. This suggests an oral spreading of the peristaltic activity (antiperistalsis). Experimental model of antiperistalsis was performed on dogs with chronically implanted electrodes on the gastric and duodenal muscle wall. Carbachol 5 micrograms/kg i.m. evoked bursts of spike potentials first with duodenal slow waves and after that with the gastric slow potentials. The antiperistaltic spreading of the spike activity in dog corresponded to the appearance of high-amplitude waves first in the record of the human small intestine, followed by sequence of high-amplitude waves in the stomach. Thus, the non-invasive recording of the electrical activity of the stomach and small intestines gives reliable information about the direction of the spreading of the peristaltic activity.

摘要

在一台原创的胃电图仪上,对健康志愿者以及恶心呕吐患者的胃和小肠上部的电活动进行了无创记录。根据波幅区分出两种波:低幅波,对应移行性肌电复合波(MMC)的静止期;波幅约为低幅波两倍的高幅波,表征MMC的活动期(蠕动活动)。小肠的低幅波和高幅波之间也存在一些差异。从胃记录到的高幅波序列之后通常紧接着从小肠记录到的高幅波序列,呈现出MMC活动期从胃向小肠的向肛传播。然而,在一些患者中,高幅波首先从十二指肠记录中引出,之后才出现在胃记录中。这表明蠕动活动存在向口传播(反蠕动)。在胃和十二指肠肌壁上长期植入电极的狗身上建立了反蠕动的实验模型。肌肉注射5微克/千克的卡巴胆碱首先诱发十二指肠慢波的动作电位爆发,之后是胃慢电位的动作电位爆发。狗的动作电位活动的反蠕动传播与人类小肠记录中首先出现高幅波,随后胃中出现高幅波序列的情况相对应。因此,对胃和小肠电活动进行无创记录能够提供关于蠕动活动传播方向的可靠信息。

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