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犬空肠和回肠纵行平滑肌对外源性去神经支配的肾上腺素能反应差异

Differential adrenergic response to extrinsic denervation in canine longitudinal jejunal and ileal smooth muscle.

作者信息

Zyromski Nicholas J, Duenes Judy A, Kendrick Michael L, Libsch Karen D, Seiler Roland, Tanaka Toshiyuki, Sarr Michael G

机构信息

Gastroenterology Research Unit and Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

J Gastrointest Surg. 2002 May-Jun;6(3):418-25. doi: 10.1016/s1091-255x(02)00006-9.

Abstract

Early postoperative complications after small bowel transplantation (SBT) are likely mediated, at least in part, by dysmotility caused by the obligate disruption of extrinsic and enteric nerves in the graft. Adrenergic hypersensitivity of gut smooth muscle has been observed in some (but not all) segments of intestine in various experimental models of SBT, highlighting regional and species variability in response to denervation. Little is known about changes in canine longitudinal muscle after extrinsic denervation. Six dogs each underwent either complete extrinsic denervation of the jejunoileum or a control operation (transection and reanastomosis of the proximal jejunum and distal ileum). In vitro contractile response of longitudinal muscle strips to norepinephrine was evaluated at the time of the operation, and 2 weeks and 8 weeks later. After extrinsic denervation, the jejunal response to norepinephrine was preserved at all time points; however, the ileum displayed a decreased sensitivity to norepinephrine, an effect unmasked after intramural neural blockade with tetrodotoxin. These data support a potential for neurally mediated dysmotility after SBT and reinforce the differences in responses to extrinsic denervation between species, as well as differences within different regions and between anatomic segments of small intestine in the same species.

摘要

小肠移植(SBT)术后早期并发症可能至少部分是由移植肠中外源性和肠内神经的必然中断所导致的运动障碍介导的。在各种SBT实验模型中,已在部分(但并非所有)肠段观察到肠道平滑肌的肾上腺素能超敏反应,这突出了去神经支配反应中的区域和物种差异。关于犬类纵行肌在外源性去神经支配后的变化知之甚少。六只犬分别接受了空肠回肠的完全外源性去神经支配或对照手术(近端空肠和远端回肠横断并重新吻合)。在手术时、术后2周和8周评估纵行肌条对去甲肾上腺素的体外收缩反应。外源性去神经支配后,空肠对去甲肾上腺素的反应在所有时间点均得以保留;然而,回肠对去甲肾上腺素的敏感性降低,在用河豚毒素进行壁内神经阻滞后这种效应被揭示出来。这些数据支持了SBT后神经介导的运动障碍的可能性,并强化了物种之间对外源性去神经支配反应的差异,以及同一物种小肠不同区域和解剖段之间的反应差异。

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