Department of Medicine, University of Adelaide, Adelaide, SA, Australia.
Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
Neurogastroenterol Motil. 2020 Oct;32(10):e13835. doi: 10.1111/nmo.13835. Epub 2020 Mar 13.
High-resolution manometric studies below the stomach are rare due to technical limitations of traditional manometry catheters. Consequently, specific motor patterns and their impact on gastric and small bowel function are not well understood. High-resolution manometry was used to record fed-state motor patterns in the antro-jejunal segment and relate these to fasting motor function.
Antro-jejunal pressures were monitored in 15 healthy females using fiber-optic manometry (72 sensors at 1 cm intervals) before and after a high-nutrient drink.
Postprandial motility showed a previously unreported transition point 18.8 cm (range 13-28 cm) beyond the antro-pyloric junction. Distal to the transition, a zone of non-propagating, repetitive pressure events (11.5 ± 0.5 cpm) were dominant in the fed state. We have named this activity, the duodeno-jejunal complex (DJC). Continuous DJC activity predominated, but nine subjects also exhibited intermittent clusters of DJC activity, 7.4 ± 4.9/h, lasting 1.4 ± 0.55 minutes, and 3.8 ± 1.2 minutes apart. DJC activity was less prevalent during fasting (3.6 ± 3.3/h; P = .04). 78% of fed and fasting state propagating antro-duodenal pressure events terminated proximally or at the transition point and were closely associated with DJC clusters.
High-resolution duodeno-jejunal manometry revealed a previously unrecognized transition point and associated motor pattern extending into the jejunum, consistent with the duodenal brake previously identified fluoroscopically. Timing suggests DJC activity is driven by chyme stimulating duodenal mucosal chemosensors. These findings indicate that the duodenum and proximal jejunum consists of two major functional motor regions.
由于传统测压导管的技术限制，胃部以下的高分辨率测压研究很少。因此，特定的运动模式及其对胃和小肠功能的影响尚不清楚。高分辨率测压用于记录进食状态下的胃-空肠段运动模式，并将其与空腹运动功能相关联。
在高营养饮料前后，使用光纤测压法（72 个传感器，间隔 1 厘米）监测 15 名健康女性的胃-空肠压力。
餐后动力显示出一个以前未报道的转折点，在胃-幽门交界处后 18.8 厘米（范围 13-28 厘米）。在该点之后，一个非传播、重复压力事件的区域（11.5±0.5 cpm）在进食状态下占主导地位。我们将这种活动命名为十二指肠-空肠复合区（DJC）。连续的 DJC 活动占主导地位，但 9 名受试者也表现出间歇性 DJC 活动簇，7.4±4.9/h，持续 1.4±0.55 分钟，间隔 3.8±1.2 分钟。DJC 活动在空腹时较少发生（3.6±3.3/h；P=0.04）。78%的进食和空腹状态下的传播性胃-十二指肠压力事件在近端或转折点处终止，并与 DJC 簇密切相关。
高分辨率的十二指肠-空肠测压法揭示了一个以前未被识别的转折点和相关的运动模式，延伸到空肠，与以前通过荧光透视法识别的十二指肠制动一致。时间提示 DJC 活动是由刺激十二指肠黏膜化学感受器的食糜驱动的。这些发现表明，十二指肠和近端空肠由两个主要的功能运动区域组成。
