Mollen R M, Hopman W P, Kuijpers H H, Jansen J B
Department of Surgery, University Hospital Nijmegen, The Netherlands.
Digestion. 2000;62(2-3):185-93. doi: 10.1159/000007812.
BACKGROUND/AIM: Because cholecystokinin and peptide YY are gut hormones with potent effects on gastrointestinal motility, we determined whether abnormalities of cholecystokinin and peptide YY exist in slow transit constipation.
Plasma concentrations of these hormones before, during and after intraduodenal infusion of a liquid meal in 21 patients with slow transit constipation were compared with the results in 8 healthy controls.
Fasting levels of plasma cholecystokinin (3.1+/-0.2 vs. 2.4+/-0.2 pM; p = 0.02) were higher in patients. Basal plasma peptide YY (11.4+/-1.4 vs. 8.9+/-0.7 pM; p = 0.1) tended to be higher in patients. After the meal (60-90 min), incremental cholecystokinin (p<0.05), but not peptide YY, was significantly higher in patients. During intraduodenal infusion of the meal (0-60 min), incremental plasma cholecystokinin (251+/-20 pM.min) and peptide YY (1,146+/-186 pM. min) in patients were almost similar to control values (262+/-22 and 901+/-166 pM. min). Gallbladder volumes before, during and after the meal were not different between the 2 groups. Gastric emptying of a solid meal was delayed in the majority of patients (12 of 18). Abnormalities of plasma cholecystokinin were observed only in patients with delayed gastric emptying.
Plasma levels of cholecystokinin are elevated in the fasting state and decrease more slowly after stimulation, but maximum release in response to intestinal nutrients is not altered in patients with slow transit constipation. The abnormality seems to be confined to a subgroup of patients with delayed gastric emptying.
背景/目的：由于胆囊收缩素和肽YY是对胃肠动力有强大作用的胃肠激素，我们研究了慢传输型便秘患者是否存在胆囊收缩素和肽YY异常。
比较21例慢传输型便秘患者和8例健康对照者在十二指肠内输注流食前、中、后的血浆这些激素浓度。
患者空腹血浆胆囊收缩素水平（3.1±0.2对2.4±0.2 pM；p = 0.02）较高。患者基础血浆肽YY（11.4±1.4对8.9±0.7 pM；p = 0.1）有升高趋势。进食后（60 - 90分钟），患者胆囊收缩素增量（p<0.05）显著高于肽YY。在十二指肠内输注流食期间（0 - 60分钟），患者血浆胆囊收缩素增量（251±20 pM·min）和肽YY增量（1146±186 pM·min）与对照值（262±22和901±166 pM·min）几乎相似。两组进食前、中、后胆囊容积无差异。大多数患者（18例中的12例）固体食物胃排空延迟。仅在胃排空延迟的患者中观察到血浆胆囊收缩素异常。
慢传输型便秘患者空腹状态下血浆胆囊收缩素水平升高，刺激后下降更慢，但对肠道营养物质的最大释放未改变。这种异常似乎局限于胃排空延迟的患者亚组。
