Grisoni E, De Agustin J C, Kalhan S C
Department of Surgery, Case Western Reserve University, Cleveland, OH.
J Pediatr Surg. 1993 Sep;28(9):1117-20. doi: 10.1016/0022-3468(93)90143-9.
Vasoactive intestinal peptide (VIP), which causes relaxation of gastrointestinal smooth muscle, has been found in high concentrations in the pylorus in many animal species, suggesting a prominent role for VIP in the control of pyloric sphincter function. We infused VIP into the gastric artery of 6 rabbits at rates from 12 to 1,200 ng/min and measured the intensity, duration, and frequency of spontaneous pyloric contractions with an intraluminal balloon and electromyography. VIP produced a dose-dependent reduction in the intensity (55% +/- 15% of baseline, P < .001) and the duration (29% +/- 25%, P < .001) of pyloric contraction. Maximal inhibition was observed at an infusion rate of 240 ng/min. The frequency of contractions did not decrease significantly in response to VIP infusion. Neostigmine infusion increased the intensity of pyloric contraction in a dose-dependent manner in doses of 0.10, 0.15, and 0.25 mg (140% +/- 78%, 273% +/- 76%, and 357% +/- 26% of baseline, respectively; P < .001). VIP infusion at 12 ng/min and 480 ng/min completely inhibited the increased intensity of contraction at neostigmine doses of 0.10 and 0.15 mg, respectively. Our results show that VIP decreases the intensity and the duration of pyloric contraction in a dose-dependent manner. As pyloric spasm may contribute to the pathogenesis of hypertrophic pyloric stenosis, we can postulate a role for reduced VIP-induced relaxation in the pathophysiology of hypertrophic pyloric stenosis.
血管活性肠肽(VIP)可引起胃肠平滑肌松弛,在许多动物物种的幽门中发现其浓度很高,这表明VIP在控制幽门括约肌功能方面发挥着重要作用。我们以12至1200 ng/分钟的速率将VIP注入6只兔子的胃动脉,并使用腔内气囊和肌电图测量自发性幽门收缩的强度、持续时间和频率。VIP使幽门收缩的强度(为基线的55%±15%,P<.001)和持续时间(为基线的29%±25%,P<.001)呈剂量依赖性降低。在输注速率为240 ng/分钟时观察到最大抑制作用。收缩频率对VIP输注无明显降低。新斯的明输注在剂量为0.10、0.15和0.25 mg时以剂量依赖性方式增加幽门收缩强度(分别为基线的140%±78%、273%±76%和357%±26%;P<.001)。分别以12 ng/分钟和480 ng/分钟的速率输注VIP时,可完全抑制新斯的明剂量为0.10和0.15 mg时收缩强度的增加。我们的结果表明,VIP以剂量依赖性方式降低幽门收缩的强度和持续时间。由于幽门痉挛可能是肥厚性幽门狭窄发病机制的一个因素,我们可以推测VIP诱导的舒张功能降低在肥厚性幽门狭窄的病理生理学中起一定作用。