Zlatkina A R, Bezzubik K V, Peeters T L, Kuznetsova O G
Sov Med. 1990(10):14-8.
Motilin basal level and that after carbohydrate load were radioimmunoassayed in 26 patients with ulcerative colitis. The results were correlated with the data on motor evacuatory activity of the gastrointestinal tract and clinical manifestations of diarrhea. Basal motilin level was found elevated as against the control (99 rg/ml) in all the patients and surpassed the norm (356-1001 rg/ml) in 6. A significant elevation of motilin content was associated with reduction of the amplitude and number of rhythmic type I contractions, as well as by increased number of type III (propulsive) waves and accelerated transport of the contents via the small intestine. No compensatory rarefying of acid discharge from the stomach, that was observed in reference subjects if transport of contents was accelerated, was detectable in the patients with ulcerative colitis. This resulted in acidification of the enteral medium (pH 5.6 +/- 0.6). Concomitant pancreatitis in 22 patients with reduced production of HCO3- and impaired cavitary hydrolysis of polymer substrate enhanced enteral medium acidification and changed its osmotic pressure. Specific features of enteral medium homeostasis disorders and of impairments of the gastrointestinal tract motor evacuatory function should be borne in mind when planning treatment strategy for diarrhea patients.
对26例溃疡性结肠炎患者的胃动素基础水平及碳水化合物负荷后的胃动素水平进行了放射免疫测定。结果与胃肠道运动排空活动数据及腹泻临床表现相关。发现所有患者的胃动素基础水平均高于对照组(99 pg/ml),6例患者超过正常范围(356 - 1001 pg/ml)。胃动素含量的显著升高与I型节律性收缩的幅度和数量减少有关,还与III型(推进性)波数量增加及内容物通过小肠的转运加速有关。在溃疡性结肠炎患者中未检测到像对照受试者那样在内容物转运加速时出现的胃内酸分泌代偿性减少。这导致肠内介质酸化(pH 5.6 +/- 0.6)。22例伴有HCO3-生成减少及聚合物底物腔水解受损的胰腺炎患者,其肠内介质酸化增强且渗透压改变。在为腹泻患者制定治疗策略时,应考虑肠内介质稳态紊乱及胃肠道运动排空功能受损的具体特点。