Ledeboer M, Masclee A A, Batstra M R, Jansen J B, Lamers C B
Department of Gastroenterology-Hepatology, University Hospital of Leiden, The Netherlands.
Gut. 1995 Jan;36(1):39-44. doi: 10.1136/gut.36.1.39.
The effect of cholecystokinin (CCK) on the lower oesophageal sphincter (LOS) pressure, frequency of transient LOS relaxations, and the number of reflux episodes was investigated in six healthy subjects. LOS pressure was recorded on four separate occasions during continuous intravenous infusion of either saline or CCK-33 in doses of 0.25, 0.5, or 1.0 Ivy Dog units per kg body weight per hour (IDU.kg-1.h-1) for 90 minutes. Plasma CCK concentrations did not change during saline infusion, but increased significantly from 2.5 (0.3) pmol/l to steady state levels of 4.0 (0.4) pmol/l, 6.1 (0.4) pmol/l, and 9.3 (0.9) pmol/l respectively starting from 30 minutes. LOS pressure did not change significantly during infusion of saline or of CCK-33 at doses of 0.25 or 0.5 IDU.kg-1.h-1. However, a significant (p < 0.05) reduction in LOS pressure to a minimum level of 12 (4) mm Hg at 30 minutes compared with basal level (18 (4) mm Hg) and compared with saline was observed during infusion of CCK-33 at a dose of 1.0 IDU.kg-1.h-1. In addition, oesophageal motility and pH were recorded simultaneously in these six subjects on two separate occasions one hour before (fasting) and three hours during administration of a gastric load (dextrose 5%, pH 3) combined with continuous intravenous infusion of saline or CCK-33 at a dose of 1.0 IDU,kg-1.h-1. Plasma CCK concentrations did not change during the gastric load combined with saline, but increased significantly to a steady state level of 10.8 (0.8) pmol/l during intravenous infusion of CCK. The number of transient LOS relaxations increased significantly in the first hour during administration of the gastric load compared with fasting levels, both during saline infusion (fasting: 1.7 (0.6)/h, 1st hour: 4.3 (1.2)/h) and during CCK infusion (fasting: 1.7 (0.5)/h, 1st hour: 3.8 (0.7)/h). In the second and third hours the number of transient LOS relaxations fell to fasting levels in both experiments. No significant differences were observed in the number and type of transient LOS relaxations, mechanism of gastro-oesophageal reflux, or duration of acid exposure between the two experiments. It is concluded that in healthy subjects infusion of CCK-33 in a dose of 1.0 IDU.kg-1.h-1 significantly reduces LOS pressure but does not affect the frequency of transient LOS relaxations or acid exposure time during a continuous liquid gastric load.
在6名健康受试者中，研究了胆囊收缩素（CCK）对食管下括约肌（LOS）压力、LOS短暂松弛频率及反流发作次数的影响。在连续静脉输注生理盐水或CCK-33期间，分4次记录LOS压力，CCK-33的剂量为每千克体重每小时0.25、0.5或1.0 Ivy Dog单位（IDU·kg⁻¹·h⁻¹），持续90分钟。输注生理盐水期间血浆CCK浓度无变化，但从30分钟开始，分别显著升高至稳态水平4.0（0.4）pmol/L、6.1（0.4）pmol/L和9.3（0.9）pmol/L。输注生理盐水或0.25或0.5 IDU·kg⁻¹·h⁻¹剂量的CCK-33期间，LOS压力无显著变化。然而，在输注1.0 IDU·kg⁻¹·h⁻¹剂量的CCK-33期间，与基础水平（18（4）mmHg）及生理盐水相比，30分钟时LOS压力显著降低（p<0.05），降至最低水平12（4）mmHg。此外，在这6名受试者中，在给予胃负荷（5%葡萄糖，pH 3）前1小时（禁食）及给药期间3小时，分2次同时记录食管动力和pH，同时连续静脉输注生理盐水或1.0 IDU·kg⁻¹·h⁻¹剂量的CCK-33。给予胃负荷并输注生理盐水期间血浆CCK浓度无变化，但静脉输注CCK期间显著升高至稳态水平10.8（0.8）pmol/L。与禁食水平相比，给予胃负荷的第1小时，LOS短暂松弛次数显著增加，输注生理盐水期间（禁食：1.7（0.6）次/小时，第1小时：4.3（1.2）次/小时）及输注CCK期间（禁食：1.7（0.5）次/小时，第1小时：3.8（0.7）次/小时）均如此。在第2和第3小时，两个实验中LOS短暂松弛次数均降至禁食水平。两个实验在LOS短暂松弛的次数和类型、胃食管反流机制或酸暴露持续时间方面未观察到显著差异。结论是，在健康受试者中，输注1.0 IDU·kg⁻¹·h⁻¹剂量的CCK-33可显著降低LOS压力，但在持续液体胃负荷期间不影响LOS短暂松弛频率或酸暴露时间。
