Gabryelewicz A, Kulesza E, Konturek S J
Gastroenterological Clinic, Academy of Medicine, Bialystok, Poland.
Scand J Gastroenterol. 1990 Jul;25(7):731-8. doi: 10.3109/00365529008997600.
The effects of loxiglumide, a potent cholecystokinin (CCK)-receptor antagonist, and atropine, a muscarinic receptor blocker, on exocrine pancreatic secretion stimulated by hormones (secretin plus CCK) and a Lundh test meal were studied in healthy young volunteers. Loxiglumide infused intravenously in gradually increasing doses (2-16 mumol/kg-h) caused a dose-dependent inhibition of pancreatic enzyme secretion induced by intravenous infusion of a constant dose of secretin (82 pmol/kg-h) plus CCK-8 (85 pmol/kg-h) but had relatively smaller influence on duodenal volume flow and bicarbonate output. Atropine (20 nmol/kg) also caused a significant reduction in pancreatic enzyme secretion but failed to affect the volume flow or bicarbonate secretion induced by secretin plus CCK, possibly owing to the high doses of secretin and CCK used in these tests. Both loxiglumide and atropine inhibited the pancreatic enzyme response to a Lundh meal, but atropine was more effective in the early phase and loxiglumide in the late phase of the postprandial secretion. Neither loxiglumide nor atropine affected the plasma gastrin and CCK levels, but both antagonists reduced plasma pancreatic polypeptide responses to the Lundh meal. We conclude that 1) loxiglumide results in a relatively stronger suppression of the pancreatic enzyme than aqueous-alkaline secretion induced by secretin plus CCK, whereas atropine inhibits only enzyme secretion; and 2) both loxiglumide and atropine suppress the pancreatic enzyme responses to the meal stimulation without affecting the postprandial plasma gastrin and CCK responses.
在健康年轻志愿者中，研究了强效胆囊收缩素（CCK）受体拮抗剂洛西格列胺和毒蕈碱受体阻滞剂阿托品对激素（促胰液素加CCK）和伦德试验餐刺激的胰腺外分泌的影响。静脉内逐渐增加剂量（2 - 16 μmol/kg-h）输注洛西格列胺，可导致静脉输注恒定剂量促胰液素（82 pmol/kg-h）加CCK-8（85 pmol/kg-h）诱导的胰腺酶分泌呈剂量依赖性抑制，但对十二指肠容积流量和碳酸氢盐输出的影响相对较小。阿托品（20 nmol/kg）也可导致胰腺酶分泌显著减少，但未能影响促胰液素加CCK诱导的容积流量或碳酸氢盐分泌，这可能是由于这些试验中使用的促胰液素和CCK剂量较高。洛西格列胺和阿托品均抑制了胰腺对伦德餐的酶反应，但阿托品在餐后分泌的早期阶段更有效，而洛西格列胺在后期阶段更有效。洛西格列胺和阿托品均未影响血浆胃泌素和CCK水平，但两种拮抗剂均降低了血浆胰多肽对伦德餐的反应。我们得出结论：1）洛西格列胺对促胰液素加CCK诱导的胰腺酶分泌的抑制作用相对强于对水性碱性分泌的抑制作用，而阿托品仅抑制酶分泌；2）洛西格列胺和阿托品均抑制胰腺对餐刺激的酶反应，而不影响餐后血浆胃泌素和CCK反应。
