Behrns K E, Sarr M G
Department of Surgery, Mayo Clinic Rochester, Minnesota 55905.
Dig Dis Sci. 1994 Aug;39(8):1665-71. doi: 10.1007/BF02087773.
Ingestion of a meal converts the fasting motor pattern, the migrating motor complex (MMC), to a fed pattern of motility. The role of specific anatomic gut regions involved in these changing patterns of motility and the neurohormonal factors which mediate these changes, however, are unknown. Our aim was to determine the neurohormonal mechanisms by which nutrients within the duodenal lumen alter proximal jejunal motility. Fifteen dogs were prepared with a gastric cannula, duodenal infusion catheter, duodenal and proximal jejunal manometry catheters, and a totally diverting cannula in the most proximal portion of the jejunum. Ten of the dogs also underwent complete in situ neural isolation of the entire jejunoileum. Experiments were performed in the fasting state with no infusion (0 ml/min) and during a 5-hr duodenal infusion (3 ml/min) of either a nonnutrient electrolyte solution or a mixed nutrient solution while diverting distal duodenal chyme from the jejunum. During sham infusion (0 ml/min), the MMC was present in neurally intact dogs (group 1) and dogs with neurally isolated jejunoileum (group 2). Nonnutrient infusion did not inhibit or consistently alter the MMC in either group. Nutrient infusion limited to the duodenum inhibited the MMC in both duodenum and jejunum in dogs with neurally intact and neurally isolated jejunoileum. Latency of onset of the fed pattern in the duodenum and jejunum did not differ between groups. We conclude that postprandial inhibition of the MMC in the jejunum is mediated, in part, by a hormonal mechanism induced by duodenal lumenal nutrients.
摄入一顿饭会将空腹运动模式,即移行性运动复合波(MMC),转变为进食后的运动模式。然而,参与这些不断变化的运动模式的特定解剖肠道区域的作用以及介导这些变化的神经激素因素尚不清楚。我们的目的是确定十二指肠腔内营养物质改变空肠近端运动的神经激素机制。对15只狗进行了如下准备:插入胃插管、十二指肠输注导管、十二指肠和空肠近端测压导管,并在空肠最近端插入一个完全分流插管。其中10只狗还对整个空肠回肠进行了完全的原位神经隔离。实验在禁食状态下进行,不进行输注(0毫升/分钟),以及在5小时内以3毫升/分钟的速度对十二指肠输注非营养电解质溶液或混合营养溶液,同时将十二指肠远端食糜从空肠分流。在假输注(0毫升/分钟)期间,神经完整的狗(第1组)和空肠回肠神经隔离的狗(第2组)中均存在MMC。非营养输注在两组中均未抑制或持续改变MMC。在神经完整和神经隔离的空肠回肠的狗中,十二指肠和空肠中进食模式开始的潜伏期在两组之间没有差异。我们得出结论,空肠中MMC的餐后抑制部分是由十二指肠腔内营养物质诱导的激素机制介导的。