Spiller R C, Brown M L, Phillips S F
Gastroenterology. 1986 Jul;91(1):100-7. doi: 10.1016/0016-5085(86)90445-2.
To determine whether the presence of unabsorbed fat in the colon altered colonic motility, intraluminal pressures were recorded in the terminal ileum and proximal colon, and serial 1-min gamma camera scans were obtained while test solutions labeled with diethylenetetramine pentaacetic acid chelate of indium 111 were infused into the middle portion of the ascending colon. Seven subjects received a control solution, and 6 subjects received an emulsion of oleic acid (4.3 g/100 ml). Oleic acid accelerated colonic transit; isotope accumulated in the rectosigmoid faster in the first 120 min (4343 +/- 1175 cpm) than it did during control infusion (1236 +/- 348 cpm; p less than 0.01). Accelerated transit of oleate was accompanied by high amplitude (greater than 60 mmHg, range 60-95 mmHg), prolonged (greater than 10 s, range 10-48 s), propagated pressure waves; they originated near the ileocecal junction at a median frequency of 1.3 times/hour (mean 4.1, range 0.4-15.7). These were associated with a narrow image of the ascending colon on scintiscan and movement of 65.9% +/- 6.5% of counts from the ascending to transverse colon over the succeeding 4 min. A similar sequence was seen only once in 33 h of infusion with control solutions (p less than 0.01). Associated with these responses, the total volume of infusate tolerated before defecation was less with oleate than with control solutions (311 +/- 21 ml vs. 1049 +/- 71 ml; p less than 0.01). Long-chain fatty acids stimulated unusual motor patterns and reduced the reservoir function of the ascending colon; these effects may contribute to the diarrhea of patients with fat malabsorption.
为了确定结肠中未吸收脂肪的存在是否会改变结肠运动，在回肠末端和近端结肠记录腔内压力，并在将用铟111的二乙三胺五乙酸螯合物标记的测试溶液注入升结肠中部时，进行连续1分钟的γ相机扫描。7名受试者接受对照溶液，6名受试者接受油酸乳剂（4.3克/100毫升）。油酸加速结肠转运；在前120分钟内，同位素在直肠乙状结肠中积累得比对照输注期间更快（4343±1175计数每分钟）（1236±348计数每分钟；p<0.01）。油酸转运加速伴随着高幅度（大于60 mmHg，范围60 - 95 mmHg）、持续时间长（大于10秒，范围10 - 48秒）的传播压力波；它们起源于回盲部附近，中位频率为每小时1.3次（平均4.1，范围0.4 - 15.7）。这些与闪烁扫描上升结肠的狭窄图像以及在随后4分钟内65.9%±6.5%的计数从升结肠向横结肠的移动有关。在输注对照溶液的33小时内仅出现过一次类似序列（p<0.01）。与这些反应相关的是，排便前耐受的输注液总体积，油酸组比对照溶液组少（311±21毫升对1049±71毫升；p<0.01）。长链脂肪酸刺激了异常的运动模式并降低了升结肠的储存功能；这些作用可能导致脂肪吸收不良患者的腹泻。
