Firpo Matthew A, Rollins Michael D, Szabo Aniko, Gull Justin D, Jackson Jeffrey D, Shao Yuanlin, Glasgow Robert E, Mulvihill Sean J
Department of Surgery, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132, USA.
BMC Gastroenterol. 2005 Jun 6;5:18. doi: 10.1186/1471-230X-5-18.
Gastric ileus is an unsolved clinical problem and current treatment is limited to supportive measures. Models of ileus using anesthetized animals, muscle strips or isolated smooth muscle cells do not adequately reproduce the clinical situation. Thus, previous studies using these techniques have not led to a clear understanding of the pathophysiology of ileus. The feasibility of using food intake and fecal output as simple, clinically relevant endpoints for monitoring ileus in a conscious mouse model was evaluated by assessing the severity and time course of various insults known to cause ileus.
Delayed food intake and fecal output associated with ileus was monitored after intraperitoneal injection of endotoxin, laparotomy with bowel manipulation, thermal injury or cerulein induced acute pancreatitis. The correlation of decreased food intake after endotoxin injection with gastric ileus was validated by measuring gastric emptying. The effect of endotoxin on general activity level and feeding behavior was also determined. Small bowel transit was measured using a phenol red marker.
Each insult resulted in a transient and comparable decrease in food intake and fecal output consistent with the clinical picture of ileus. The endpoints were highly sensitive to small changes in low doses of endotoxin, the extent of bowel manipulation, and cerulein dose. The delay in food intake directly correlated with delayed gastric emptying. Changes in general activity and feeding behavior were insufficient to explain decreased food intake. Intestinal transit remained unchanged at the times measured.
Food intake and fecal output are sensitive markers of gastric dysfunction in four experimental models of ileus. In the mouse, delayed gastric emptying appears to be the major cause of the anorexic effect associated with ileus. Gastric dysfunction is more important than small bowel dysfunction in this model. Recovery of stomach function appears to be simultaneous to colonic recovery.
胃麻痹是一个尚未解决的临床问题,目前的治疗仅限于支持性措施。使用麻醉动物、肌肉条或分离的平滑肌细胞构建的肠梗阻模型无法充分再现临床情况。因此,以往使用这些技术的研究未能清晰地阐明肠梗阻的病理生理学。通过评估已知可导致肠梗阻的各种损伤的严重程度和时间进程,评价了将食物摄入量和粪便排出量作为监测清醒小鼠模型中肠梗阻的简单且与临床相关的终点指标的可行性。
在内毒素腹腔注射、开腹肠管操作、热损伤或雨蛙肽诱导的急性胰腺炎后,监测与肠梗阻相关的食物摄入延迟和粪便排出延迟情况。通过测量胃排空来验证内毒素注射后食物摄入量减少与胃麻痹的相关性。还确定了内毒素对一般活动水平和进食行为的影响。使用酚红标记物测量小肠转运。
每种损伤均导致食物摄入量和粪便排出量短暂且相似的减少,与肠梗阻的临床表现一致。这些终点指标对低剂量内毒素、肠管操作程度和雨蛙肽剂量的微小变化高度敏感。食物摄入延迟与胃排空延迟直接相关。一般活动和进食行为的变化不足以解释食物摄入量的减少。在所测量的时间点,肠道转运保持不变。
在四种肠梗阻实验模型中,食物摄入量和粪便排出量是胃功能障碍的敏感标志物。在小鼠中,胃排空延迟似乎是与肠梗阻相关的厌食效应的主要原因。在该模型中,胃功能障碍比小肠功能障碍更重要。胃功能的恢复似乎与结肠恢复同步。