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迷走神经切断术对消化性溃疡患者胃抑肽释放的影响。

Influence of vagotomy upon GIP release in patients with peptic ulcer.

作者信息

Imamura M, Kameyama J, Naito H, Sato T, Ohneda A

出版信息

Tohoku J Exp Med. 1984 Jul;143(3):335-44. doi: 10.1620/tjem.143.335.

Abstract

Twenty-two vagotomized peptic ulcer patients were studied on the influence of vagotomy on the release of GIP. Moreover, the relationship between acid output and GIP release was analyzed. These patients underwent one of the three types of operation; truncal vagotomy with pyloroplasty (TV + P) selective vagotomy with pyloroplasty (SV + P) and selective vagotomy with antrectomy (SV + A). Before and after surgery, a gastric juice study and an oral glucose tolerance test were performed on separate days. Maximum acid output in response to tetragastrin correlated significantly with integrated GIP response after oral glucose loading. In the SV + P group, the response of GIP was slightly greater after surgery. In the SV + A group, the integrated GIP response diminished postoperatively, although, after surgery, GIP reached its peak sooner. The integrated GIP response was greater in the SV + P group than in the TV + P group. The response of GIP was less in the SV + A group than in the SV + P group. These changes were insignificant. In conclusion, it is presumed that GIP release is affected by gastric acid, gastric emptying time, intestinal transit time and vagal nerve action.

摘要

对22例迷走神经切断术后的消化性溃疡患者进行了迷走神经切断术对胃抑肽(GIP)释放影响的研究。此外,还分析了胃酸分泌量与GIP释放之间的关系。这些患者接受了以下三种手术之一:胃迷走神经干切断术加幽门成形术(TV + P)、选择性迷走神经切断术加幽门成形术(SV + P)以及选择性迷走神经切断术加胃窦切除术(SV + A)。手术前后,在不同日期分别进行了胃液研究和口服葡萄糖耐量试验。口服葡萄糖负荷后,对四肽胃泌素的最大胃酸分泌量与GIP的综合反应显著相关。在SV + P组中,术后GIP的反应略有增强。在SV + A组中,术后GIP的综合反应减弱,不过术后GIP达到峰值的时间更早。SV + P组的GIP综合反应大于TV + P组。SV + A组的GIP反应小于SV + P组。这些变化无显著意义。总之,推测GIP的释放受胃酸、胃排空时间、肠道转运时间和迷走神经作用的影响。

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