Bruins Maaike J, Luiking Yvette C, Soeters Peter B, Akkermans Louis M A, Deutz Nicolaas E P
Department of Surgery, Maastricht University, Maastricht, The Netherlands.
Ann Surg. 2003 Jan;237(1):44-51. doi: 10.1097/00000658-200301000-00007.
To determine the effects of hyperdynamic endotoxemia on the motility of the small intestine.
Motility disorders of the gastrointestinal tract are a common complication of sepsis. It has been suggested that gram-negative endotoxin plays a role in the pathogenesis of the accompanying diarrhea frequently observed.
Pigs were infused with lipopolysaccharide for a 24-hour period. During this fasting period jejunal motility was measured using ambulatory manometry. One and 4 days after cessation of endotoxin, pigs were enterally fed, and again motility was recorded.
Hyperdynamic endotoxemia was achieved in this model. Manometric pressure recordings revealed that endotoxin infusion accelerated the migrating motor complex (MMC) migration along the jejunum. Also, a simultaneous increase in MMC cycling frequency was observed in the endotoxin-treated group. Elevated MMC migration velocity and cycling frequency were maintained the following day after endotoxin during feeding and returned to basal values 4 days after endotoxin.
A small dose of continuously infused endotoxin significantly provokes jejunal motility disturbances that may contribute to diarrhea.
确定高动力性内毒素血症对小肠蠕动的影响。
胃肠道动力障碍是脓毒症的常见并发症。有人提出革兰氏阴性内毒素在常伴随出现的腹泻发病机制中起作用。
给猪输注脂多糖24小时。在此禁食期间,使用动态测压法测量空肠蠕动。内毒素输注停止后1天和4天,给猪进行肠内喂养,并再次记录蠕动情况。
该模型实现了高动力性内毒素血症。测压记录显示,内毒素输注加速了移行性运动复合波(MMC)沿空肠的迁移。此外,在内毒素治疗组中观察到MMC循环频率同时增加。内毒素输注后第二天,在喂养期间MMC迁移速度和循环频率升高,并在内毒素输注后4天恢复到基础值。
小剂量持续输注内毒素可显著引发空肠蠕动紊乱,这可能导致腹泻。