Nowak Lukasz, Królczyk Grzegorz, Sobocki Jacek, Zurowski Daniel, Thor Piotr J
Katedra Patofizjologii, Collegium Medicum Uniwersytetu Jagiellońskiego.
Folia Med Cracov. 2004;45(1-2):71-9.
The aim of this study was to determine the most effective current parameters reversing vasopressin (VP) induced gastroparesis by gastric electrical stimulation IGES).
Twenty male healthy Wistar rats were included into the study (weight 227 +/- 24 g). Animals were subjected to gastric fistula placement and implantation of two monopolar electrodes for EGG-studies and GES. After 5 days of recovery VP was applied (terlipressin 0.1 mg/kg i.p.) The gastric motility was measured by means of balloon introduced into the stomach through the fistula. The gastric electrical and motor activity were recorded by the PowerLab/8SP system and software. Electrical signals were cleared by 3000 AC/DC differential amplifier A-M System Inc. Gastric electrical stimulation (GES) was generated by Zimmer stimulator SINUS5. The following currents: S01 (monopolar): ampl 2.2 mA, freq 29 Hz, on/off 1 s / 10 s; S02 (bipolar): ampl 2.2 mA, freq 29 Hz, on/off 1s/10s: S03 (monopolar): ampl 2.2 mA, freq 0.5 Hz: S04 (monopolar): ampl 2.2 mA, freq 34 Hz, on/off 5.5 s/15 s were used.
The phasic contractions almost disappeared and amplitude decreased from 12 +/- 5 to 2.9 +/- 1.5 cm H20. The motility index decreased from 276,3 +/- 76.4 to 154.6 +/- 63 cm H2O x s/min. GES S01-S04 increased motility index to: 167.6 +/- 60.8: 155.1 +/- 89.3; 170.3 +/- 92.3: 301.9 +/- 70.5 cm H2O x s/min respectively. The frequency of gastric slow wave increased from 0.04 +/- 0.02 to 0.07 +/- 0.02 Hz after VP administration. GES S01-S04 reversed VP induced increase of slow wave frequency to 0.06 +/- 0.02, 0.055 +/- 0.02, 0.06 +/- 0.01 and 0.04 +/- 0.02 Hz, respectively.
This effectiveness of local GES and the pressure pattern of induced gastroparesis suggest peripheral complex inhibitory-excitatory action of vasopressin on gastric smooth muscles. The mechanism of this action may involve the enteric nervous system, gastric and vasal smooth muscles. The most effective in reversing VP induced functional gastroparesis is high frequency current applied in timing of the natural slow wave.
本研究的目的是确定通过胃电刺激（IGES）逆转血管加压素（VP）诱导的胃轻瘫的最有效电流参数。
20只雄性健康Wistar大鼠（体重227±24g）纳入本研究。动物接受胃瘘管置入和植入两个单极电极用于胃电图研究和胃电刺激。恢复5天后给予VP（特利加压素0.1mg/kg腹腔注射）。通过经瘘管插入胃内的球囊测量胃动力。胃电和运动活动由PowerLab/8SP系统和软件记录。电信号由A-M系统公司的3000交流/直流差分放大器清除。胃电刺激（GES）由Zimmer刺激器SINUS5产生。使用以下电流：S01（单极）：振幅2.2mA，频率29Hz，开/关1s/10s；S02（双极）：振幅2.2mA，频率29Hz，开/关1s/10s；S03（单极）：振幅2.2mA，频率0.5Hz；S04（单极）：振幅2.2mA，频率34Hz，开/关5.5s/15s。
相性收缩几乎消失，振幅从12±5降至2.9±1.5cmH2O。动力指数从276.3±76.4降至154.6±63cmH2O×s/min。GES S01 - S04使动力指数分别增加至：167.6±60.8；155.1±89.3；170.3±92.3；301.9±70.5cmH2O×s/min。给予VP后胃慢波频率从0.04±0.02增加至0.07±'0.02Hz。GES S01 - S04分别将VP诱导的慢波频率增加逆转至0.06±0.02、0.055±0.02、0.06±0.01和0.04±0.02Hz。
局部GES的这种有效性以及诱导胃轻瘫的压力模式提示血管加压素对胃平滑肌具有外周复杂的抑制 - 兴奋作用。这种作用机制可能涉及肠神经系统、胃和血管平滑肌。逆转VP诱导的功能性胃轻瘫最有效的方法是在自然慢波的时间应用高频电流。
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