Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan.
Kaohsiung J Med Sci. 2019 May;35(5):310-314. doi: 10.1002/kjm2.12059. Epub 2019 Mar 21.
Secondary peristalsis contributes to the clearance of the refluxate from the esophagus. Acute administration of 5-hydroxytryptamine 4 (5-HT ) receptors agonist, mosapride or esophageal infusion of hydrochloric acid (HCl) facilitates secondary peristalsis. The aim of this study was to determine whether esophageal acid infusion and administration of mosapride had different effects on secondary peristalsis. Secondary peristalsis was performed with esophageal distension with rapid and slow air injections in 16 healthy subjects. We performed two separate sessions with HCl (0.1 N) and 40 mg oral mosapride to compare their influence on secondary peristaltic parameters. The threshold volume of secondary peristalsis was significantly lower with HCl infusion than mosapride (P = 0.01) by slow air injections. The threshold volume to generate secondary peristalsis was significantly lower with HCl infusion than mosapride (P = 0.002) by rapid air injections. More secondary peristalsis was trigged by rapid air injections after HCl infusion than mosapride (P = 0.003). Infusion of HCl or mosapride administration has similar effects on peristaltic wave amplitude and duration of primary and secondary peristalsis. Acute esophageal acid infusion can induce greater mechanosensitivity to distension-induced secondary peristalsis than 5-HT receptors agonist mosapride. The data suggest that acid-sensitive afferents are more likely to contribute to sensory modulation of esophageal secondary peristalsis; however, the motility aspects of secondary peristalsis are comparable between acute esophageal acidification and 5-HT receptors activation via mosapride.
次级蠕动有助于将反流物从食管清除。5-羟色胺 4（5-HT）受体激动剂莫沙必利或盐酸（HCl）的食管内灌注可促进次级蠕动。本研究的目的是确定食管酸灌注和莫沙必利给药对次级蠕动是否有不同的影响。在 16 名健康受试者中，通过快速和缓慢空气注射扩张食管来进行次级蠕动。我们进行了两次单独的 HCl（0.1N）和 40mg 口服莫沙必利的实验，以比较它们对次级蠕动参数的影响。通过缓慢空气注射，HCl 灌注的次级蠕动阈值体积明显低于莫沙必利（P=0.01）。通过快速空气注射，HCl 灌注的次级蠕动阈值体积明显低于莫沙必利（P=0.002）。与莫沙必利相比，HCl 灌注后通过快速空气注射触发的次级蠕动更多（P=0.003）。HCl 灌注或莫沙必利给药对原发性和继发性蠕动的蠕动波幅度和持续时间具有相似的影响。急性食管酸化可引起对扩张诱导的次级蠕动的机械敏感性增加，而 5-HT 受体激动剂莫沙必利则不能。这些数据表明，酸敏感传入纤维更有可能参与食管次级蠕动的感觉调制；然而，通过急性食管酸化和莫沙必利激活 5-HT 受体，次级蠕动的运动方面是相当的。
