Carmagnola Stefania, Cantù Paolo, Penagini Roberto
Cattedra di Gastroenterologia, Dipartimento di Scienze Mediche, University of Milan-IRCCS, Ospedale Maggiore, Milan, Italy.
Am J Gastroenterol. 2005 Aug;100(8):1704-10. doi: 10.1111/j.1572-0241.2005.41350.x.
To assess the role of tension receptors in gastric perception by pharmacologically modifying gastric contractile activity during isovolumetric distensions of the proximal stomach with the hypothesis that relaxation decreased perception and contraction increased it.
Fourteen healthy subjects underwent two 30-min isovolumetric (75% of the threshold volume for discomfort) distensions using a barostat. During the second distension, either gastric relaxation was induced by intravenous (i.v.) glucagon 4.8 microg/kg bolus plus 9.6 microg/kg per h or contraction by i.v. erythromycin 3 mg/kg. Hunger and fullness were assessed with a 100-mm analog scale before and at 15 and 30 min during each distension.
Glucagon decreased baseline intrabag pressure (8.4 +/- 1.0 vs 10.7 +/- 1.3 mmHg; p < 0.05) and abolished the pressure waves (0 vs 16.7 +/- 2.3) when compared with placebo, whereas erythromycin increased baseline pressure (13.2 +/- 1.0 vs 11.9 +/- 0.9 mmHg; p < 0.05) and the rate of pressure waves (31.7 +/- 5.4 vs 20.5 +/- 3.1; p < 0.05). Fullness increased (p < 0.05) during distension, but it was unaffected by either of the drugs: Delta score (i.e., score during distension--baseline score) of 38 +/- 10 mm (glucagon) versus 22 +/- 10 (placebo) and 24 +/- 17 mm (erythromycin) versus 36 +/- 14 (placebo) at 15 min. Similar observation were made at 30 min. Hunger was influenced neither by distension nor by any of the two drugs consistently.
Our data do not support a prominent role of tension receptors of the proximal stomach on perception of fullness, suggesting that stretch, that is, volume, is the more relevant stimulus.
通过在近端胃等容扩张期间药理学调节胃收缩活动，评估张力感受器在胃感觉中的作用，假设松弛会降低感觉而收缩会增强感觉。
14名健康受试者使用恒压器进行两次30分钟的等容（不适阈值体积的75%）扩张。在第二次扩张期间，通过静脉注射4.8微克/千克推注加9.6微克/千克每小时的胰高血糖素诱导胃松弛，或通过静脉注射3毫克/千克的红霉素诱导胃收缩。在每次扩张前以及扩张期间15分钟和30分钟时，使用100毫米模拟量表评估饥饿感和饱腹感。
与安慰剂相比，胰高血糖素降低了基线袋内压力（8.4±1.0对10.7±1.3毫米汞柱；p<0.05）并消除了压力波（0对16.7±2.3），而红霉素增加了基线压力（13.2±1.0对11.9±0.9毫米汞柱；p<0.05）和压力波频率（31.7±5.4对20.5±3.1；p<0.05）。扩张期间饱腹感增加（p<0.05），但两种药物均未对其产生影响：15分钟时，胰高血糖素组的Δ评分（即扩张期间评分-基线评分）为38±10毫米，而安慰剂组为22±10毫米；红霉素组为24±17毫米，而安慰剂组为36±14毫米。30分钟时观察结果相似。饥饿感既不受扩张影响，也不受两种药物中任何一种的持续影响。
我们的数据不支持近端胃张力感受器在饱腹感感知中起重要作用，表明拉伸，即体积，是更相关的刺激因素。
