Tougas G, Fitzpatrick D, Hudoba P, Talalla A, Shine G, Hunt R H, Upton A R
Division of Gastroenterology, McMaster University Medical Centre, Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.
Pacing Clin Electrophysiol. 1992 Oct;15(10 Pt 2):1588-96. doi: 10.1111/j.1540-8159.1992.tb02938.x.
We examined the effects of chronic left vagal electrostimulation on afferent and efferent gastrointestinal vagal function in eight patients. Afferent function was assessed using cortical evoked responses to electrical stimulation of the esophagus and to direct vagal stimulation using the implanted left vagal electrode. Efferent gastrointestinal vagal function was measured by examining the basal, maximal, and sham fed stimulated gastric acid output prior to and with chronic left vagal electrostimulation. Esophageal electrostimulation produced a cortical evoked response consisting of three negative and three positive peaks within 400 msec after stimulation. Prior to vagal electrostimulation the mean conduction velocity of the afferent signal was measured at 8.72 +/- 3.39 m/sec, compatible with A-delta fibers involvement. Basal, maximal, and sham fed acid output were 1.11, 21.87, and 9.37 mmol/hour, respectively. The evoked response to esophageal electrical stimulation was not changed with chronic left vagal electrostimulation. Direct vagal stimulation also produced evoked potentials that were comparable to those obtained with esophageal stimulation. The mean conduction velocity was 6.26 +/- 2.72 m/sec (NS) so that there was no evidence of loss of myelinated fibers with chronic stimulation. No differences were detected in basal (1.29 mmol/h), maximal (21.64 mmol/h), or sham fed stimulated (8.03 mmol/h) acid output, showing that vagal electrostimulation has no effect on either total or vagally mediated acid output, an efferent vagal function. In conclusion, chronic left vagal electrostimulation has no significant adverse effect on gastrointestinal vagal function.
我们研究了慢性左迷走神经电刺激对8例患者胃肠道迷走神经传入和传出功能的影响。使用对食管电刺激以及使用植入的左迷走神经电极进行直接迷走神经刺激所产生的皮层诱发电位来评估传入功能。通过检测慢性左迷走神经电刺激之前及刺激过程中的基础胃酸分泌量、最大胃酸分泌量以及假饲刺激后的胃酸分泌量，来测定胃肠道迷走神经传出功能。食管电刺激在刺激后400毫秒内产生了一个由三个负峰和三个正峰组成的皮层诱发电位。在迷走神经电刺激之前，传入信号的平均传导速度测得为8.72±3.39米/秒，这与A-δ纤维参与其中相符。基础胃酸分泌量、最大胃酸分泌量以及假饲刺激后的胃酸分泌量分别为1.11、21.87和9.37毫摩尔/小时。慢性左迷走神经电刺激并未改变对食管电刺激的诱发电位反应。直接迷走神经刺激也产生了与食管刺激所获得的诱发电位相当的电位。平均传导速度为6.26±2.72米/秒（无显著差异），因此没有证据表明慢性刺激会导致有髓纤维丧失。在基础胃酸分泌量（1.29毫摩尔/小时）、最大胃酸分泌量（21.64毫摩尔/小时）或假饲刺激后的胃酸分泌量（8.03毫摩尔/小时）方面未检测到差异，这表明迷走神经电刺激对总的或迷走神经介导的胃酸分泌量（一种迷走神经传出功能）均无影响。总之，慢性左迷走神经电刺激对胃肠道迷走神经功能没有显著的不良影响。
