Luiking Y C, Akkermans L M A, van der Reijden A C, Peeters T L, van Berge-Henegouwen G P
Gastrointestinal Research Unit, Department of Surgery, University Medical Centre Utrecht, The Netherlands.
Neurogastroenterol Motil. 2003 Apr;15(2):103-11. doi: 10.1046/j.1365-2982.2003.00395.x.
Motilin was infused in this study with the aim of examining refractory characteristics for motilin stimulation of antral phase III and fasting gallbladder emptying. Moreover, interdigestive pyloric and small intestinal motility from duodenum to ileum were studied, as these may be target organs for motilin. Eight fasting, healthy male volunteers received, on separate subsequent days, repeated infusions of 13leucine-motilin (8 pmol (kg min)(-1) for 5 min) or saline at 30 min after phase IIIs in the duodenum. Interdigestive motility of the antrum, pylorus, duodenum, jejunum and ileum was measured for maximum 10 h by using a 21-lumen perfused catheter. Gallbladder motility was measured by ultrasonography. Motilin infusions induced antral phase IIIs, but only after a preceding phase III of duodenal origin. Under this condition, time-interval to phase III at the duodenal recording site was 30 +/- 13 (SEM) min after motilin, compared with 79 +/- 14 min after saline (P < 0.01), and compared with 121 +/- 13 min for motilin infusion following an antral phase III (P < 0.001). Motilin did not affect small intestinal motility or isolated pyloric pressure waves (IPPWs). However, the number of IPPWs was significantly affected by the origin of the preceding phase III, irrespective of whether motilin or saline was infused. Gallbladder volume decreased significantly within 10 min after each motilin infusion. We conclude that this study clearly demonstrates differential regional effects of motilin. Motilin initiates antral phase IIIs, but stimulation is subject to a refractory period which is clearly prolonged after a preceding antral phase III. Motilin induced gallbladder emptying, however, is not subject to a refractory state. Small intestinal phase IIIs as well as pyloric IPPWs are not affected by motilin.
在本研究中输注胃动素，目的是检测胃动素刺激胃窦Ⅲ期和空腹胆囊排空的不应期特征。此外，还研究了从十二指肠到回肠的消化间期幽门和小肠运动，因为这些可能是胃动素的靶器官。8名空腹健康男性志愿者在随后不同的日子里，于十二指肠Ⅲ期后30分钟分别接受重复输注13亮氨酸 - 胃动素（8 pmol(kg·min)(-1)，持续5分钟）或生理盐水。使用21腔灌注导管，对胃窦、幽门、十二指肠、空肠和回肠的消化间期运动进行最长10小时的测量。通过超声检查测量胆囊运动。胃动素输注可诱导胃窦Ⅲ期，但仅在十二指肠起源的前一个Ⅲ期之后。在此条件下，胃动素输注后十二指肠记录部位到Ⅲ期的时间间隔为30±13（标准误）分钟，而生理盐水输注后为79±14分钟（P<0.01），与胃窦Ⅲ期后输注胃动素的121±13分钟相比（P<0.001）。胃动素不影响小肠运动或孤立的幽门压力波（IPPWs）。然而，无论输注的是胃动素还是生理盐水，IPPWs的数量都受到前一个Ⅲ期起源的显著影响。每次胃动素输注后10分钟内胆囊体积显著减小。我们得出结论，本研究清楚地证明了胃动素的不同区域效应。胃动素启动胃窦Ⅲ期，但刺激存在不应期，在前一个胃窦Ⅲ期后明显延长。然而，胃动素诱导的胆囊排空不受不应期状态的影响。小肠Ⅲ期以及幽门IPPWs不受胃动素影响。
