Chesta J, Generini G, Antezana C, Defilippi C
Centro de Gastroenterologia, Hospital Clinico, Universidad de Chile.
Rev Med Chil. 1992 Sep;120(9):998-1002.
Patients with liver cirrhosis develop marked abnormalities in small bowel motility and high plasma glucagon levels. Disturbances in small intestinal motor activity could be related to hyperglucagonemia. To investigate the relationship between fasting plasma glucagon levels and changes in small bowel motility in patients with liver cirrhosis, eighteen cirrhotic patients and ten controls were studied. Plasma glucagon was measured by RIA. Mouth to cecum transit time was estimated by lactulose hydrogen breath test. Fasting small bowel motility was investigated by means of intraluminal manometry. Plasma glucagon levels were significantly higher in patients with cirrhosis (61 +/- 5 pmol/l) than in controls (32 +/- 3 pmol/l); p < 0.01. In patients with liver disease, plasma glucagon levels were not significantly correlated to mouth to cecum transit time (r: -0.32), duration of migrating motor complex (r: -0.24), nor to the frequency of multiple clustered contractions (r: -0.26). The degree of small bowel dysmotility is not related to plasma glucagon levels in patients with hepatic cirrhosis. These results do not support the hypothesis that hyperglucagonemia plays an important pathogenic role in the abnormalities of gut motility in cirrhosis.
肝硬化患者小肠运动出现明显异常，且血浆胰高血糖素水平升高。小肠运动活动紊乱可能与高胰高血糖素血症有关。为研究肝硬化患者空腹血浆胰高血糖素水平与小肠运动变化之间的关系，对18例肝硬化患者和10例对照者进行了研究。采用放射免疫分析法测定血浆胰高血糖素。通过乳果糖氢呼气试验估算口至盲肠转运时间。通过腔内测压法研究空腹小肠运动。肝硬化患者的血浆胰高血糖素水平（61±5 pmol/l）显著高于对照组（32±3 pmol/l）；p<0.01。在肝病患者中，血浆胰高血糖素水平与口至盲肠转运时间（r：-0.32）、移行性运动复合波持续时间（r：-0.24）以及多发成簇收缩频率（r：-0.26）均无显著相关性。肝硬化患者小肠运动障碍程度与血浆胰高血糖素水平无关。这些结果不支持高胰高血糖素血症在肝硬化患者肠道运动异常中起重要致病作用这一假说。
