Heddle R, Fone D, Dent J, Horowitz M
Gastroenterology Unit, Royal Adelaide Hospital, South Australia.
Gut. 1988 Oct;29(10):1349-57. doi: 10.1136/gut.29.10.1349.
Recent studies suggest that the pylorus may play an important role in the regulation of the gastric emptying of nutrient liquids in man. Dextrose solutions in the range 5-25 g/dl have been reported to empty from the human stomach at a constant caloric rate of 2.1 kcal/min. This study examined, in 12 healthy volunteers, the effects of intraduodenal dextrose on pyloric motility. Dextrose solutions, 5, 10, 15, and 25 gde/dl and saline solutions, 0.9 and 2.7 g/dl were infused into the duodenum at 4 ml/min for 10 minutes. Antral, pyloric, and duodenal motility were monitored with sideholes and a sleeve sensor positioned across the pylorus. Significant increases in the rate of isolated pyloric pressure waves and in basal pyloric pressure were seen with 15 and 25 g/dl dextrose (p less than 0.02) and 2.7 g/dl saline (p less than 0.05). The intensity and duration of the phasic and tonic pyloric motor responses to intraduodenal dextrose were dose dependent and correlated directly with the rate of calorie delivery (p less than 0.005 for each parameter). Intraduodenal delivery of dextrose at a rate in excess of 2.1 kcal/min stimulates both phasic and tonic pyloric contraction. These changes in pyloric motility may contribute to the close regulation of the emptying of dextrose from the stomach.
最近的研究表明,幽门可能在人体营养性液体胃排空的调节中发挥重要作用。据报道,浓度在5 - 25克/分升范围内的葡萄糖溶液以2.1千卡/分钟的恒定热量速率从人胃中排空。本研究在12名健康志愿者中检测了十二指肠内注入葡萄糖对幽门运动的影响。将5、10、15和25克/分升的葡萄糖溶液以及0.9和2.7克/分升的盐溶液以4毫升/分钟的速度注入十二指肠,持续10分钟。通过侧孔和横跨幽门放置的袖带传感器监测胃窦、幽门和十二指肠的运动。15和25克/分升的葡萄糖(p < 0.02)以及2.7克/分升的盐溶液(p < 0.05)可使孤立的幽门压力波速率和基础幽门压力显著增加。十二指肠内注入葡萄糖后,幽门的阶段性和紧张性运动反应的强度和持续时间呈剂量依赖性,且与热量输送速率直接相关(每个参数p < 0.005)。以超过2.1千卡/分钟的速率在十二指肠内注入葡萄糖会刺激幽门的阶段性和紧张性收缩。幽门运动的这些变化可能有助于密切调节葡萄糖从胃中的排空。