Edelbroek M, Schuurkes J, De Ridder W, Horowitz M, Dent J, Akkermans L
Department of Surgery, University Hospital, Utrecht, The Netherlands.
Dig Dis Sci. 1995 Apr;40(4):901-11. doi: 10.1007/BF02064998.
The myoelectrical and motor response of the antropyloroduodenal region to intraduodenal nutrient stimulation or antral tachygastria represent useful models for, respectively, physiological and pathophysiological gastric stasis to test the efficacy of prokinetic drugs. We evaluated the effects of an intravenous bolus of cisapride (0.63 mg/kg) on the myoelectrical and motor response of the antropyloroduodenal region to an intraduodenal triglyceride emulsion (10% Intralipid, 0.5 ml/min) or antral tachygastria in conscious dogs. Intraduodenal lipid suppressed antral motility (P < 0.05, compared to intraduodenal saline) and stimulated phasic pyloric contractions (P < 0.01, compared to intraduodenal saline), a motor pattern known to be associated with delayed gastric emptying. During intraduodenal lipid stimulation cisapride virtually abolished all isolated pyloric motor events (P < 0.05) and stimulated antral and duodenal motility (P < 0.05 for both) and antropyloroduodenal coordination (65% versus 15%; P < 0.05). Antral tachygastria was associated with a higher number of isolated pyloric motor events in the fasted state [0.8 (0.7-1.1) per minute versus 0.2 (0-0.3) per minute; P < 0.05], but not during intraduodenal lipid stimulation [1.1 (0.9-1.7) per minute versus 1.2 (1.0-1.9) per minute; NS]. Cisapride decreased the number and duration of spontaneous episodes of antral tachygastria during intraduodenal saline and lipid infusion (P < 0.05 for both) and abolished the tachygastria-associated motor patterns. Cisapride induced a 20% decrease in the antral slow-wave frequency during intraduodenal saline and lipid, irrespective of gastric pacemaker rhythm. We conclude that: (1) cisapride overcomes feedback from small intestinal lipid receptors on myoelectrical and motor activities of the antropyloroduodenal region and decreases antral slow-wave frequency, and (2) cisapride inhibits antral tachygastria and tachygastria-associated motor patterns. These effects may contribute to the effective gastrokinetic properties of cisapride in physiological and certain forms of pathophysiological gastric stasis.
胃幽门十二指肠区域对十二指肠内营养物质刺激或胃窦快速胃动的肌电和运动反应，分别代表了用于测试促动力药物疗效的生理性和病理性胃潴留的有用模型。我们评估了静脉推注西沙必利（0.63mg/kg）对清醒犬胃幽门十二指肠区域对十二指肠内甘油三酯乳剂（10%英脱利匹特，0.5ml/min）或胃窦快速胃动的肌电和运动反应的影响。十二指肠内脂质抑制胃窦运动（与十二指肠内生理盐水相比，P<0.05）并刺激阶段性幽门收缩（与十二指肠内生理盐水相比，P<0.01），这种运动模式已知与胃排空延迟有关。在十二指肠内脂质刺激期间，西沙必利几乎消除了所有孤立的幽门运动事件（P<0.05），并刺激了胃窦和十二指肠运动（两者均P<0.05）以及胃幽门十二指肠协调性（65%对15%；P<0.05）。胃窦快速胃动在禁食状态下与更多的孤立幽门运动事件相关[每分钟0.8（0.7 - 1.1）次对每分钟
0.2（0 - 0.3）次；P<0.05]，但在十二指肠内脂质刺激期间并非如此[每分钟1.1（0.9 - 1.7）次对每分钟1.2（1.0 - 1.9）次；无显著性差异]。西沙必利在十二指肠内注入生理盐水和脂质期间减少了胃窦快速胃动的自发发作次数和持续时间（两者均P<0.05），并消除了与快速胃动相关的运动模式。无论胃起搏点节律如何，西沙必利在十二指肠内注入生理盐水和脂质期间使胃窦慢波频率降低了20%。我们得出结论：（1）西沙必利克服了小肠脂质受体对胃幽门十二指肠区域肌电和运动活动的反馈，并降低胃窦慢波频率，（2）西沙必利抑制胃窦快速胃动和与快速胃动相关的运动模式。这些作用可能有助于西沙必利在生理性和某些形式的病理性胃潴留中发挥有效的胃肠动力特性。
