Nealon W H, Upp J R, Alexander R W, Gomez G, Townsend C M, Thompson J C
Department of Surgery, University of Texas Medical Branch, Galveston 77550.
Am J Physiol. 1990 Aug;259(2 Pt 1):G173-8. doi: 10.1152/ajpgi.1990.259.2.G173.
Gallbladder stasis during prolonged total parenteral nutrition (TPN) has been documented. We have examined the effect of intravenous amino acid infusion on human gallbladder contraction and release of cholecystokinin (CCK). Five healthy adult volunteers were given amino acid infusions at different rates (65, 125, 240, and 600 mg.kg-1.h-1). The volume of the gallbladder was calculated by means of ultrasonographic measurements. Plasma samples were analyzed for CCK immunoreactivity. Gallbladder and hormone responses after intravenous amino acids were compared with responses after a fat meal, after a protein meal, and after ingestion of an oral amino acid mixture. We found that intravenous amino acids stimulated human gallbladder contraction in a dose-related manner. The mechanism of stimulation may be through the release of CCK although significant correlation was not demonstrated. The magnitude of response is similar to that seen after meal stimulation. To compare the delivery of amino acids during a standard meal and during each dose of intravenous amino acids, peripheral plasma levels of dietary amino acids were measured after a standard commercially prepared enteral supplement meal and after each dose of intravenous amino acids. Our lower doses of amino acid infused resulted in levels of circulating amino acid comparable to those after a meal. The induction of gallbladder contraction and release of CCK in human recipients of parenteral nutrition may be of value in some circumstances.
长期全胃肠外营养(TPN)期间胆囊淤滞已有文献记载。我们研究了静脉输注氨基酸对人体胆囊收缩及胆囊收缩素(CCK)释放的影响。5名健康成年志愿者以不同速率(65、125、240和600mg·kg-1·h-1)输注氨基酸。通过超声测量计算胆囊容积。分析血浆样本中的CCK免疫反应性。将静脉输注氨基酸后的胆囊和激素反应与进食脂肪餐、蛋白质餐及口服氨基酸混合物后的反应进行比较。我们发现静脉输注氨基酸以剂量相关方式刺激人体胆囊收缩。刺激机制可能是通过CCK的释放,尽管未显示出显著相关性。反应程度与进食刺激后相似。为比较标准餐和每次静脉输注氨基酸期间氨基酸的输送情况,在食用标准商业制备的肠内补充剂餐及每次静脉输注氨基酸后,测量外周血浆中膳食氨基酸水平。我们输注的较低剂量氨基酸导致循环氨基酸水平与进食后相当。在某些情况下,肠外营养受者中胆囊收缩的诱导及CCK的释放可能具有价值。