Bharucha A E, Camilleri M, Ford M J, O'Connor M K, Hanson R B, Thomforde G M
Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota, USA.
Gastroenterology. 1996 Aug;111(2):368-77. doi: 10.1053/gast.1996.v111.pm8690201.
BACKGROUND & AIMS. Hyperventilation-induced hypocapnia affects hemodynamic function and enhances colonic motility. The aims of this study were to determine the effects of hypocapnic hyperventilation on colonic motility and sensation in health and to explore the putative neurohumoral mechanisms.
In experiment 1, colonic tone, sensation, plasma levels of cortisol, beta-endorphin, selected gut neuropeptides, norepinephrine, epinephrine, and splanchnic blood volume were measured during two sequences of hypocapnic hyperventilation. In experiment 2, colonic tone and sensation were assessed during eucapnic hyperventilation and abdominal compression.
Hypocapnic hyperventilation, but not eucapnic hyperventilation or abdominal compression, significantly increased colonic tone and sensitivity to balloon distention (P = 0.017) without altering humoral mediators or splanchnic blood volume. Plasma norepinephrine level increased (P = 0.017) and splanchnic blood volume decreased (P = 0.028) during 5 minutes after hyperventilation, consistent with homeostatic responses.
Increased colonic tone and sensation during hypocapnic hyperventilation are not caused by colonic compression. These effects of hyperventilation are not mediated humorally but may result from direct metabolic effects of hypocapnia on colonic muscle or from changes in central autonomic control of colonic smooth muscle.
背景与目的。过度通气引起的低碳酸血症会影响血流动力学功能并增强结肠蠕动。本研究的目的是确定低碳酸血症性过度通气对健康状态下结肠蠕动和感觉的影响,并探索可能的神经体液机制。
在实验1中,在两个低碳酸血症性过度通气序列期间测量结肠张力、感觉、血浆皮质醇、β-内啡肽、选定的肠道神经肽、去甲肾上腺素、肾上腺素和内脏血容量水平。在实验2中,在等碳酸血症性过度通气和腹部按压期间评估结肠张力和感觉。
低碳酸血症性过度通气而非等碳酸血症性过度通气或腹部按压显著增加了结肠张力和对球囊扩张的敏感性(P = 0.017),而未改变体液介质或内脏血容量。过度通气后5分钟内血浆去甲肾上腺素水平升高(P = 0.017),内脏血容量降低(P = 0.028),这与稳态反应一致。
低碳酸血症性过度通气期间结肠张力和感觉的增加并非由结肠受压引起。过度通气的这些影响并非由体液介导,而是可能源于低碳酸血症对结肠肌肉的直接代谢作用或源于结肠平滑肌中枢自主控制的变化。