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大鼠高选择性迷走神经切断术:对骨骼和矿物质代谢的影响。

Highly selective vagotomy in the rat: effects on bone and mineral metabolism.

作者信息

Rümenapf G, Schwille P O, Wagner W, Tiecks F P, Fries W, Galewski D

机构信息

Dept. of Surgery, University of Erlangen, Germany.

出版信息

Scand J Gastroenterol. 1994 Mar;29(3):232-7. doi: 10.3109/00365529409090469.

Abstract

Highly selective vagotomy (HSV) or sham operation was performed in male rats. Fifteen weeks later bone mineralization, fractional intestinal absorption and balance, urinary excretion, and serum levels of calcium, magnesium and phosphorus, together with serum gastrin, parathyroid hormone, calcitonin, vitamin D metabolites, osteocalcin, isoenzymes of alkaline phosphatase, and the urinary excretion of cyclic AMP and hydroxyproline were assessed. HSV induced chronic hypergastrinemia and enhanced the weight of the fundus, antrum, and pancreas. Body weight, food intake, intestinal absorption, mineral balance, and bone mineralization were unaffected by HSV, whereas serum parathyroid hormone levels and urinary hydroxyproline excretion were increased. It is concluded that in the rat 1) HSV has a trophic effect on gastric and extragastric tissues; 2) gastric acid production is not a major determinant of intestinal calcium absorption; and 3) normal bone mass in the presence of signs of hyperparathyroidism indicates an intrinsic capacity of HSV to interfere with calcium metabolism, probably via hypergastrinemia, gastrin being an element of the gastro-parathyroid axis. Our present findings underscore the fact that osteopenia after HSV in man may be a rare finding, but it cannot be ruled out that bone disease found after partial or total gastrectomy may be due in part to concomitant vagotomy.

摘要

对雄性大鼠实施高选择性迷走神经切断术(HSV)或假手术。15周后,评估骨矿化、小肠吸收分数及平衡、尿排泄,以及钙、镁、磷的血清水平,同时评估血清胃泌素、甲状旁腺激素、降钙素、维生素D代谢产物、骨钙素、碱性磷酸酶同工酶,以及环磷酸腺苷和羟脯氨酸的尿排泄。HSV诱导慢性高胃泌素血症,并增加胃底、胃窦和胰腺的重量。体重、食物摄入量、小肠吸收、矿物质平衡和骨矿化不受HSV影响,而血清甲状旁腺激素水平和尿羟脯氨酸排泄增加。得出以下结论:在大鼠中,1)HSV对胃和胃外组织有营养作用;2)胃酸分泌不是小肠钙吸收的主要决定因素;3)存在甲状旁腺功能亢进迹象时骨量正常表明HSV可能通过高胃泌素血症干扰钙代谢的内在能力,胃泌素是胃-甲状旁腺轴的一个要素。我们目前的研究结果强调了这样一个事实,即人类HSV术后骨质减少可能是罕见发现,但不能排除部分或全胃切除术后发现的骨病可能部分归因于伴随的迷走神经切断术。

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