Kellow J E, Miller L J, Phillips S F, Zinsmeister A R, Charboneau J W
Gastroenterology Unit, Mayo Clinic, Rochester, Minnesota 55905.
Am J Physiol. 1987 Nov;253(5 Pt 1):G650-5. doi: 10.1152/ajpgi.1987.253.5.G650.
We compared responses of the gallbladder to graded intravenous infusions of cholecystokinin octapeptide (CCK-OP) in normal controls (n = 8) and patients with irritable bowel syndrome (IBS) with predominant constipation (n = 8) or diarrhea (n = 8). The doses of CCK-OP ranged from subphysiological (negligible contraction of the gallbladder) to supraphysiological (90% contraction of gallbladder and abdominal side effects) amounts. All gallbladders contracted progressively in response to CCK-OP, and a Weibull model (power exponential function) described precisely the gallbladder's response to CCK-OP. Patients with IBS responded differently from normal patients; those with constipation contracted their gallbladders more and those with diarrhea contracted less in response to the peptide. Gallbladders were also stimulated with a high-fat, liquid meal; all patients' gallbladders contracted, but clear differences between groups could not be demonstrated postprandially. The results suggest that the smooth muscle of the gallbladder in IBS has an abnormal sensitivity to CCK-OP, and the results support the concept that IBS can be a generalized abnormality of the smooth muscle of the digestive tract.
我们比较了正常对照组（n = 8）、以便秘为主的肠易激综合征（IBS）患者（n = 8）和以腹泻为主的IBS患者（n = 8）胆囊对静脉注射不同剂量八肽胆囊收缩素（CCK - OP）的反应。CCK - OP的剂量范围从低于生理剂量（胆囊收缩可忽略不计）到高于生理剂量（胆囊收缩90%且出现腹部副作用）。所有胆囊对CCK - OP均呈进行性收缩，并且威布尔模型（幂指数函数）精确描述了胆囊对CCK - OP的反应。IBS患者与正常患者的反应不同；便秘型患者胆囊收缩更强，而腹泻型患者对该肽的胆囊收缩较弱。还用高脂流食刺激胆囊；所有患者的胆囊均收缩，但餐后各组之间未显示出明显差异。结果表明，IBS患者胆囊平滑肌对CCK - OP具有异常敏感性，这些结果支持IBS可能是消化道平滑肌广泛性异常的观点。
