Hirsch D P, Tiel-Van Buul M M, Tytgat G N, Boeckxstaens G E
Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Dig Dis Sci. 2000 Oct;45(10):2069-75. doi: 10.1023/a:1005611221617.
In a previous study we showed that nitric oxide (NO) synthesis inhibition by NG-monomethyl-L-arginine (L-NMMA) reduced the number of transient lower esophageal sphincter relaxations (TLESRs) triggered by gastric balloon distention. The role of NO in postprandial TLESRs and gastroesophageal reflux, however, is unknown. Therefore, we studied the effect of L-NMMA on meal-induced TLESRs and reflux episodes with simultaneous recording of esophageal peristalsis, intraesophageal and intragastric pH, and gastric emptying in healthy volunteers. Ingestion of a solid meal resulted in an increase in TLESRs [8.5 (6.3-11.0) 60 min] which was significantly inhibited by L-NMMA [6.0 (4.0-8.8) 60 min, P < 0.05]. In addition, the total number of reflux episodes was reduced. L-NMMA had no effect on intragastric meal distribution and gastric emptying, but attenuated the postprandial increase in intragastric pH. These results confirm the involvement of NO in the neurocircuitry underlying the triggering of TLESRs. The reduction in reflux by L-NMMA has to be confirmed in patients with gastroesophageal reflux disease. NO may be involved in the regulation of gastric acid secretion.
在之前的一项研究中，我们发现，NG-单甲基-L-精氨酸（L-NMMA）抑制一氧化氮（NO）合成可减少胃气囊扩张引发的一过性下食管括约肌松弛（TLESRs）的次数。然而，NO在餐后TLESRs和胃食管反流中的作用尚不清楚。因此，我们在健康志愿者中研究了L-NMMA对进餐诱发的TLESRs和反流发作的影响，同时记录食管蠕动、食管内和胃内pH值以及胃排空情况。摄入固体餐会导致TLESRs增加[8.5（6.3 - 11.0）次/60分钟]，而L-NMMA可显著抑制这一增加[6.0（4.0 - 8.8）次/60分钟，P < 0.05]。此外，反流发作的总数也减少了。L-NMMA对胃内餐食分布和胃排空没有影响，但减弱了餐后胃内pH值的升高。这些结果证实了NO参与了TLESRs触发的神经回路。L-NMMA减少反流的作用有待在胃食管反流病患者中得到证实。NO可能参与胃酸分泌的调节。
