Kohagen K R, Kim M S, McDonnell W M, Chey W D, Owyang C, Hasler W L
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
Gastroenterology. 1996 Jan;110(1):3-11. doi: 10.1053/gast.1996.v110.pm8536873.
BACKGROUND & AIMS: Mechanisms of antral hypomotility with smoking are unknown. Slow wave disruption, which may be prostaglandin dependent, inhibits gastric motility. This study tested if nicotine reproduces motor effects of smoking and assessed the role of slow wave disruption in inducing hypomotility and the prostaglandin dependence of dysrhythmic responses.
Electrogastrography and antroduodenal manometry were performed in 9 nonsmokers and 9 smokers during transdermal nicotine treatment (14 mg). Studies were repeated after administration of 150 mg indomethacin daily for 3 days to test prostaglandin requirements of nicotine responses.
Antral migrating motor complex periodicity and fasting and fed motility indices, not different in the groups under control conditions, decreased similarly in nonsmokers and smokers with nicotine. Tachygastria (> 4.5 cycle/min) increased from 2% +/- 2% to 16% +/- 3% of recording time, and arrhythmias (frequency instability index) increased from 0.5 +/- 0.1 to 1.1 +/- 0.2 cycle/min with nicotine in nonsmokers (P < 0.05), which normalized with indomethacin. Electrogastrography results were unchanged in smokers.
Nicotine evokes antral hypomotility in nonsmokers and smokers but evokes prostaglandin-dependent gastric dysrhythmias only in nonsmokers. Smokes show desensitization to nicotine-stimulated dysrhythmias. Thus, slow wave disruption is not essential to inhibit motor activity. This provides a model for the motor and myoelectric effects of smoking.
吸烟导致胃窦动力不足的机制尚不清楚。慢波紊乱可能依赖前列腺素,会抑制胃动力。本研究检测尼古丁是否会重现吸烟对运动的影响,并评估慢波紊乱在诱发动力不足中的作用以及心律失常反应对前列腺素的依赖性。
对9名不吸烟者和9名吸烟者进行经皮尼古丁治疗(14毫克)期间的胃电图和胃十二指肠测压。在每日服用150毫克吲哚美辛3天后重复进行研究,以测试尼古丁反应对前列腺素的需求。
在对照条件下两组无差异的胃窦移行运动复合波周期以及空腹和进食时的动力指数,在接受尼古丁治疗的不吸烟者和吸烟者中均有类似下降。非吸烟者中,胃动过速(>4.5次/分钟)从记录时间的2%±2%增加到16%±3%,心律失常(频率不稳定指数)从0.5±0.1次/分钟增加到1.1±0.2次/分钟(P<0.05),吲哚美辛可使其恢复正常。吸烟者的胃电图结果未改变。
尼古丁在不吸烟者和吸烟者中均可诱发胃窦动力不足,但仅在不吸烟者中诱发依赖前列腺素的胃心律失常。吸烟者对尼古丁刺激的心律失常表现出脱敏。因此,慢波紊乱对抑制运动活动并非必不可少。这为吸烟的运动和肌电效应提供了一个模型。