Nilsson B I, Svenberg T, Tollström T, Hellström P M, Samuelson K, Schnell P O
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Acta Physiol Scand. 1990 May;139(1):55-61. doi: 10.1111/j.1748-1716.1990.tb08897.x.
The aim of this study was to elucidate the importance of biliary output for the regulation of migrating motor complex and the release of plasma motilin. Gallbladder emptying was monitored by hepatobiliary scintigraphy, plasma motilin concentration by radioimmunoassay and gastrointestinal motility by a perfused catheter system. During a total recording time of 46 h and 20 min in 16 volunteers, we observed 29 episodes of gallbladder emptying, 27 plasma motilin peaks and 23 activity fronts (phase 3 activity) of the migrating motor complex (MMC). Twelve episodes of gallbladder emptying started in phase 1 and continued into phase 2 of the MMC. The remaining 17 episodes of gallbladder emptying started in phase 2, and three of these continued into phase 3 of the MMC. Biliary output was associated with a significant rise in plasma motilin concentration, whereas plasma motilin significantly decreased after the activity fronts. These observations may explain the well-known fluctuations of plasma motilin concentration in the fasted state. Motilin is released into the circulation as a result of biliary output, while the ensuing activity front of the MMC removes this stimulant from the proximal small bowel, resulting in a fall in plasma motilin. In conclusion, we have confirmed a temporal relationship between biliary output into the duodenum and the release of plasma motilin. The observed transition from phase 1 to phase 2 and from phase 2 to phase 3 of the MMC during gallbladder emptying episodes suggests that biliary output stimulates gastrointestinal motility in the fasted state.
本研究的目的是阐明胆汁排出量对移行性运动复合波调节及血浆胃动素释放的重要性。通过肝胆闪烁显像监测胆囊排空情况，采用放射免疫分析法检测血浆胃动素浓度，并利用灌注导管系统监测胃肠动力。在16名志愿者共46小时20分钟的记录时间内，我们观察到29次胆囊排空事件、27个血浆胃动素峰值以及23个移行性运动复合波（MMC）的活动波峰（第3相活动）。12次胆囊排空事件始于MMC的第1相，并持续至第2相。其余17次胆囊排空事件始于第2相，其中3次持续至MMC的第3相。胆汁排出量与血浆胃动素浓度显著升高相关，而在活动波峰后血浆胃动素显著下降。这些观察结果可能解释了禁食状态下血浆胃动素浓度众所周知的波动情况。胃动素因胆汁排出而释放入循环，而随后MMC的活动波峰将这种刺激物从小肠近端清除，导致血浆胃动素下降。总之，我们证实了十二指肠胆汁排出与血浆胃动素释放之间的时间关系。在胆囊排空事件中观察到的MMC从第1相到第2相以及从第2相到第3相的转变表明，胆汁排出在禁食状态下刺激胃肠动力。
