Krawisz B R, Miller L J, DiMagno E P, Go V L
J Lab Clin Med. 1980 Jan;95(1):13-8.
Feedback inhibition of basal pancreatic enzyme secretion by luminal pancreatic enzymes appears to be an important regulator of pancreatic secretion in some laboratory animals. To determine whether pancreatic enzymes in the jejunum influence pancreatic or gastric functions in healthy man, we intubated six subjects with a gastric sump tube and a four-lumen duodenal tube which provided (1) a duodenal perfusion site, (2) a duodenal aspiration site, (3) an inflatable balloon immediately distal to the aspiration site, and (4) a jejunal perfusion site immediately beyond the balloon. In this way, the gastroduodenal segment could be functionally separated from the remainder of the intestine. The jejunum was exposed to normal saline, active pancreatic-biliary secretions, or pancreatic-biliary secretions in which the enzymes had been inactivated by heat. Ten minutes after initiation of each jejunal perfusion, normal saline was instilled into the stomach. No differences in trypsin secretion, gastric acid secretion, or gastric emptying occurred with the different jejunal perfusates. We therefore conclude that normal man, in the absence of intraluminal nutrients, does not exhibit a jejunal pancreatic enzyme-dependent feedback control mechanism for pancreatic enzyme or gastric secretion. However, our study does not exclude the possibility of a duodenal feedback regulatory mechanism.
管腔内胰腺酶对基础胰腺酶分泌的反馈抑制在一些实验动物中似乎是胰腺分泌的重要调节机制。为了确定空肠中的胰腺酶是否会影响健康人的胰腺或胃功能,我们用胃引流管和四腔十二指肠管对6名受试者进行插管,该十二指肠管提供了:(1)一个十二指肠灌注部位;(2)一个十二指肠抽吸部位;(3)一个位于抽吸部位远端的可充气气球;(4)一个位于气球远端的空肠灌注部位。通过这种方式,胃十二指肠段可以在功能上与肠道的其余部分分离。空肠分别接受生理盐水、活跃的胰胆分泌物或其中酶已被热灭活的胰胆分泌物灌注。每次空肠灌注开始10分钟后,向胃内注入生理盐水。不同的空肠灌注液对胰蛋白酶分泌、胃酸分泌或胃排空均无影响。因此,我们得出结论,在无腔内营养物质的情况下,正常人不会表现出空肠中依赖胰腺酶的胰腺酶或胃分泌的反馈控制机制。然而,我们的研究并未排除十二指肠反馈调节机制存在的可能性。