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门腔分流术对大鼠胃的影响。

Effects of portacaval shunt on the rat stomach.

作者信息

Ekelund M, Håkanson R, Holmin T, Oscarson J, Rehfeld J F, Sundler F, Westrin P

出版信息

Acta Physiol Scand. 1985 Jul;124(3):437-47. doi: 10.1111/j.1748-1716.1985.tb07680.x.

Abstract

In portacaval-shunted rats, basal but not pentagastrin-stimulated acid secretion was higher than in sham-operated controls. The basal serum gastrin concentration was unchanged and the postprandial serum gastrin concentration lowered following portacaval shunt. Thus, gastrin is not responsible for the elevated basal acid secretion. The present study provides evidence that there is no trophic effect on the oxyntic mucosa as a whole and that there is no change in parietal cell-associated gastrin receptors after portacaval shunting. Interestingly, however, endocrine cells in the oxyntic mucosa (the histamine-containing ECL cells) proliferated greatly and the pentagastrin- and cholecystokinin octapeptide-induced activation of the histamine-forming enzyme, histidine decarboxylase, in these cells was much greater than in control rats. Analysis of the dose-response curves for the enzyme-activating effect of pentagastrin and cholecystokinin-octapeptide indicated that the D50 values for these two stimulants were not altered by shunting but that the maximal enzyme activation was greatly elevated. The enhanced enzyme activation can be partly, but not fully, explained by the fact that the ECL cells were increased in number. The enhanced response following portacaval shunt probably reflects also an increased number of gastrin receptors per ECL cell. The effect of portacaval shunting on gastric ECL cells can perhaps be explained by impaired degradation in the liver of intestinal substance(s) exerting a highly specific trophic effect on the ECL cells or, alternatively, causing an enrichment of gastrin receptors on these cells, thereby making them more sensitive to the trophic effect of gastrin. The ECL cell hyperplasia is manifest about 4 weeks after the shunting. A modified procedure for portacaval shunting which left the gastroduodenal vein (otherwise ligated) drained to the liver produced the same trophic effect as conventional portacaval shunt, suggesting an intestinal rather than gastroduodenal origin of the agent(s) responsible for the trophic action.

摘要

在门腔分流大鼠中,基础胃酸分泌高于假手术对照组,但五肽胃泌素刺激的胃酸分泌则不然。门腔分流后,基础血清胃泌素浓度未变,餐后血清胃泌素浓度降低。因此,胃泌素并非基础胃酸分泌升高的原因。本研究提供的证据表明,门腔分流对整个泌酸黏膜没有营养作用,壁细胞相关的胃泌素受体也没有变化。然而,有趣的是,泌酸黏膜中的内分泌细胞(含组胺的肠嗜铬样细胞)大量增殖,这些细胞中五肽胃泌素和八肽胆囊收缩素诱导的组胺形成酶——组氨酸脱羧酶的激活程度远高于对照大鼠。对五肽胃泌素和八肽胆囊收缩素的酶激活作用的剂量反应曲线分析表明,分流并未改变这两种刺激物的半数有效剂量(D50)值,但最大酶激活程度大幅提高。酶激活增强部分(但非全部)可由肠嗜铬样细胞数量增加来解释。门腔分流后反应增强可能还反映了每个肠嗜铬样细胞上胃泌素受体数量增加。门腔分流对胃肠嗜铬样细胞的影响或许可以解释为,对肠嗜铬样细胞具有高度特异性营养作用的肠道物质在肝脏中的降解受损,或者导致这些细胞上胃泌素受体富集,从而使其对胃泌素的营养作用更敏感。肠嗜铬样细胞增生在分流后约4周显现。一种改良的门腔分流手术,即保留胃十二指肠静脉(否则会结扎)引流至肝脏,产生了与传统门腔分流相同的营养作用,这表明负责营养作用的物质起源于肠道而非胃十二指肠。

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