Gorard D A, Healy J C, O'Donnell L J, Farthing M J
Department of Gastroenterology, St. Bartholomew's Hospital, London, UK.
Aliment Pharmacol Ther. 1994 Aug;8(4):461-4. doi: 10.1111/j.1365-2036.1994.tb00315.x.
5-Hydroxytryptamine (5-HT) is an important neurotransmitter in the enteric nervous system. The intrinsic neural plexus of the gall-bladder resembles the enteric nervous system and similarly contains 5-HT neurones. The action of 5-HT on gallbladder motility has been investigated in animals but its effect on the human gall-bladder in vivo is unknown.
The effect of indirect 5-HT agonism using paroxetine, a specific inhibitor of neuronal 5-HT reuptake, on gall-bladder motility was investigated in 12 healthy volunteers. In a randomized double-blind crossover design, gall-bladder motility was assessed after administration of 30 mg paroxetine daily for two days and after placebo. Ultrasonography was used to determine gall-bladder volumes while fasting and at 5 min intervals following a 250 kcal mixed liquid meal.
Fasting gall-bladder volumes of 21.8 +/- 3.2 ml on placebo and 28.0 +/- 3.5 ml on paroxetine were similar. Paroxetine impaired postprandial gall-bladder emptying. Residual gall-bladder volume was 10.2 +/- 2.7 ml with placebo and 17.1 +/- 2.7 ml with paroxetine (P < 0.05). Ejection fraction was 57.3 +/- 7.7% on placebo and 40.9 +/- 4.7% on paroxetine (P < 0.05).
5-HT pathways may participate in the regulation of biliary motility, and this study demonstrates an inhibitory role of 5-HT in the control of human gall-bladder emptying.
5-羟色胺（5-HT）是肠神经系统中的一种重要神经递质。胆囊的内在神经丛类似于肠神经系统，同样含有5-HT神经元。5-HT对胆囊运动的作用已在动物身上进行了研究，但其对人体胆囊的体内作用尚不清楚。
在12名健康志愿者中研究了使用帕罗西汀（一种神经元5-HT再摄取的特异性抑制剂）间接激动5-HT对胆囊运动的影响。采用随机双盲交叉设计，在每天服用30mg帕罗西汀两天后和服用安慰剂后评估胆囊运动。在空腹时以及在摄入250千卡混合流食后每隔5分钟使用超声检查来确定胆囊体积。
安慰剂组的空腹胆囊体积为21.8±3.2ml，帕罗西汀组为28.0±3.5ml，两者相似。帕罗西汀损害了餐后胆囊排空。安慰剂组的残余胆囊体积为10.2±2.7ml，帕罗西汀组为17.1±2.7ml（P<0.05）。安慰剂组的射血分数为57.3±7.7%，帕罗西汀组为40.9±4.7%（P<0.05）。
5-HT途径可能参与胆汁运动的调节，本研究证明了5-HT在控制人体胆囊排空方面具有抑制作用。
