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实验性犬霍乱中电解质丢失的部位和特征以及肠腔内葡萄糖的作用

Site and characteristics of electrolyte loss and effect of intraluminal glucose in experimental canine cholera.

作者信息

Carpenter C C, Sack R B, Feeley J C, Steenberg R W

出版信息

J Clin Invest. 1968 May;47(5):1210-20. doi: 10.1172/JCI105810.

Abstract

The site and characteristics of gastrointestinal electrolyte loss were investigated in eight dogs with experimental cholera induced by orogastric administration of 6-hr broth cultures of Vibrio cholerae, strain Ogawa 395. In these animals, all electrolyte losses originated in the small bowel, predominantly from the jejunum and ileum. The bicarbonate concentration of the small bowel fluid showed a progressive increase from duodenum, where it was less than that of plasma, to the terminal ileum, where it was significantly greater than that of simultaneously obtained plasma. Studies of the responses of chronic Thiry-Vella jejunal loops (five dogs) and chronic Thiry-Vella ileal loops (five dogs) to intraluminal challenge by cholera exotoxin demonstrated that all loops exhibited isotonic electrolyte loss for a 14-18 hr period after challenge. The bicarbonate concentration of fluid produced by exotoxin-challenged jejunal loops was not significantly different from that of plasma, whereas the ileal loops produced fluid with a bicarbonate concentration approximately three times that of plasma. The effect of intraluminal glucose on the response of canine gut to cholera exotoxin was investigated by perfusion studies in 12 dogs with chronic Thiry-Vella fistulae. Intraluminal glucose significantly enhanced isotonic fluid absorption in both jejunal and ileal loops. The net effects of glucose on isotonic fluid absorption were equal before and after intraluminal administration of crude cholera exotoxin. These data suggest that cholera exotoxin causes gut electrolyte loss by a mechanism independent of that by which glucose enhances sodium absorption.

摘要

通过经口胃管给予霍乱弧菌小川395株6小时肉汤培养物诱导八只狗患实验性霍乱,研究了胃肠道电解质丢失的部位和特征。在这些动物中,所有电解质丢失均起源于小肠,主要来自空肠和回肠。小肠液的碳酸氢盐浓度从十二指肠(低于血浆浓度)到回肠末端(显著高于同时采集的血浆浓度)呈逐渐升高趋势。对五只狗的慢性Thiry-Vella空肠袢和五只狗的慢性Thiry-Vella回肠袢对霍乱毒素腔内刺激的反应研究表明,所有肠袢在刺激后14 - 18小时内均表现出等渗性电解质丢失。受毒素刺激的空肠袢产生的液体的碳酸氢盐浓度与血浆无显著差异,而回肠袢产生的液体的碳酸氢盐浓度约为血浆的三倍。通过对12只患有慢性Thiry-Vella瘘管的狗进行灌注研究,调查了腔内葡萄糖对犬肠道对霍乱毒素反应的影响。腔内葡萄糖显著增强了空肠和回肠袢的等渗性液体吸收。腔内给予粗制霍乱毒素前后,葡萄糖对等渗性液体吸收的净效应相同。这些数据表明,霍乱毒素导致肠道电解质丢失的机制与葡萄糖增强钠吸收的机制无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/297273/3ffc4625a3d0/jcinvest00240-0265-a.jpg

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