Levan V H, Liddle R A, Green G M
Department of Physiology, University of Texas Health Science Center, San Antonio 78284-7756.
Gut. 1987;28 Suppl(Suppl):25-9. doi: 10.1136/gut.28.suppl.25.
The effect of jejunal bypass on pancreatic growth and plasma cholecystokinin (CCK) was investigated in rats. Rats underwent bypass of jejunum or sham operation. Rats with jejunal bypass were further divided into three groups; one group received a continuous infusion of a partially hydrolysed liquid diet (Vital) into the bypassed jejunum; a second group received the nutrient solution mixed with trypsin and infused into the bypassed jejunum; the third bypass group did not receive infusion of nutrient or trypsin into the jejunum. Jejunal bypass alone did not significantly stimulate pancreatic growth or DNA content at one or two weeks postoperative. Infusion of nutrient solution into the bypassed jejunum stimulated pancreatic growth and DNA content, with maximal increases of 185% and 181% for pancreatic weight and DNA content, respectively, at two weeks. This coincided with significant increases in postabsorptive plasma CCK concentrations. Infusion of pancreatic proteases into the bypassed jejunum partially reversed the effects of nutrient infusion. These results suggest that exclusion of bile-pancreatic juice or pancreatic proteases from the jejunum does not lead to maximal release of CCK unless the jejunum receives luminal nutrients. It is proposed that CCK release from rat jejunum occurs spontaneously in the absence of pancreatic proteases, and that luminal nutrients in bypassed jejunum increase plasma CCK and stimulate pancreatic growth by maintaining synthesis of CCK.
在大鼠中研究了空肠旁路术对胰腺生长和血浆胆囊收缩素(CCK)的影响。大鼠接受空肠旁路术或假手术。空肠旁路术的大鼠进一步分为三组;一组将部分水解的流质饮食(Vital)持续输注到旁路空肠中;第二组将与胰蛋白酶混合的营养液输注到旁路空肠中;第三组旁路组未向空肠输注营养物质或胰蛋白酶。单独的空肠旁路术在术后1周或2周时并未显著刺激胰腺生长或DNA含量。向旁路空肠输注营养液刺激了胰腺生长和DNA含量,在2周时胰腺重量和DNA含量分别最大增加了185%和181%。这与吸收后血浆CCK浓度的显著增加相吻合。向旁路空肠输注胰蛋白酶部分逆转了营养液输注的作用。这些结果表明,除非空肠接受肠腔内营养物质,否则将胆汁胰液或胰蛋白酶排除在空肠外不会导致CCK的最大释放。有人提出,在没有胰蛋白酶的情况下,大鼠空肠会自发释放CCK,并且旁路空肠中的肠腔内营养物质通过维持CCK的合成来增加血浆CCK并刺激胰腺生长。