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胃、胰腺和胆道对固体-液体餐或匀浆餐的不同反应。

Different gastric, pancreatic, and biliary responses to solid-liquid or homogenized meals.

作者信息

Malagelada J R, Go V L, Summerskill W H

出版信息

Dig Dis Sci. 1979 Feb;24(2):101-10. doi: 10.1007/BF01324736.

Abstract

We have compared responses to an ordinary solid-liquid (S) meal and to a homogenized (H) meal of identical composition (sirloin steak, bread, butter, ice cream with chocolate syrup, and water) by measuring simultaneously postprandial gastric, pancreatic, and biliary functions by marker-perfusion techniques. Responses to each (S or H) meals differed strikingly both in magnitude and pattern. S meals elicited a stronger early gastric secretory response (acid, pepsin, and volume) which compensated for faster initial emptying and resulted in higher gastric acidity and volume than after H meals. Further, nutrients ingested with S meals were emptied at a slower rate than H (as evidenced by a more gradual decline in intragastric buffer and osmolality, as well as time required for complete emptying of the meal). This, in turn, prolonged pancreatic and biliary responses since stimulation of these organs continued for as long as meal was delivered into the duodenum. However, early biliary outputs (gallbladder response) were less after S than H, probably because nutrients entered the duodenum more slowly and were initially diluted by rapidly emptying water. The physical characteristics of each meal (encompassing appearance, taste, and form of ingestion) probably accounted for early differences in digestive responses. Later, interactions between gastric (motor and secretory), pancreatic, and biliary functions played a major role. Our findings suggest that gastric, pancreatic, and biliary responses to liquid test meals introduced into the stomach may differ substantially from the presumably more physiological response to ordinary solid-liquid meals.

摘要

我们通过标记灌注技术同时测量餐后胃、胰腺和胆汁的功能,比较了对普通固体 - 液体(S)餐和成分相同(里脊牛排、面包、黄油、加巧克力糖浆的冰淇淋和水)的均质化(H)餐的反应。对每种(S或H)餐的反应在程度和模式上都有显著差异。S餐引发更强的早期胃分泌反应(酸、胃蛋白酶和容量),这补偿了更快的初始排空,并导致比H餐更高的胃酸度和容量。此外,与S餐一起摄入的营养物质排空速度比H餐慢(胃内缓冲液和渗透压的逐渐下降以及餐食完全排空所需的时间证明了这一点)。这反过来又延长了胰腺和胆汁的反应,因为只要餐食进入十二指肠,这些器官的刺激就会持续。然而,S餐之后的早期胆汁输出(胆囊反应)比H餐少,可能是因为营养物质进入十二指肠的速度较慢,并且最初被快速排空的水稀释。每餐的物理特性(包括外观、味道和摄入形式)可能是消化反应早期差异的原因。后来,胃(运动和分泌)、胰腺和胆汁功能之间的相互作用起了主要作用。我们的研究结果表明,胃、胰腺和胆汁对引入胃内的液体测试餐的反应可能与对普通固体 - 液体餐的推测更生理的反应有很大不同。

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