Snook J A, Wells A D, Prytherch D R, Evans D H, Bloom S R, Colin-Jones D G
Queen Alexandra Hospital, Portsmouth, Hampshire.
Gut. 1989 Dec;30(12):1716-20. doi: 10.1136/gut.30.12.1716.
A reaction indistinguishable from the early dumping syndrome was induced in four of nine normal volunteers by intraduodenal instillation of a hypertonic glucose meal. Tachycardia and marked peripheral vasodilatation were demonstrated in 'dumpers' by Doppler ultrasound measurements of the arterial blood flow signal. The dumping reaction was not detectably altered by the addition of guar to the meal. Plasma VIP concentration rose and plasma volume fell to a similar degree in 'dumpers' and 'non-dumpers', suggesting that neither event is an integral component of the dumping mechanism. In contrast, the rates of rise of blood glucose and enteroglucagon concentration were markedly greater in 'dumpers'. The results are inconsistent with the conventional explanation that the early dumping syndrome is caused by a large osmotic fluid shift, but are compatible with a mechanism involving an initial period of intestinal hypermotility.
通过十二指肠内滴注高渗葡萄糖餐，在9名正常志愿者中的4人身上诱发了一种与早期倾倒综合征难以区分的反应。通过多普勒超声测量动脉血流信号，在“倾倒者”中证实了心动过速和明显的外周血管扩张。向餐食中添加瓜尔胶后，倾倒反应没有明显改变。“倾倒者”和“非倾倒者”的血浆血管活性肠肽（VIP）浓度升高，血浆容量下降程度相似，这表明这两个事件都不是倾倒机制的组成部分。相比之下，“倾倒者”的血糖和肠高血糖素浓度上升速度明显更快。这些结果与早期倾倒综合征是由大量渗透性液体转移引起的传统解释不一致，但与涉及肠道运动亢进初期的机制相符。
