Shirohara H, Tabaru A, Otsuki M
Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
J Gastroenterol. 1996 Aug;31(4):572-7. doi: 10.1007/BF02355059.
We investigated the effect of intravenous infusions of the therapeutically available amino acid solutions Moripron and Morihepamin (Roussel Morishita, Osaka, Japan) on gallbladder contraction and cholecystokinin (CCK) release in healthy male volunteers. Plasma CCK levels were measured by radioimmunoassay, using the antibody OAL-656, which is specific for the aminoterminus of CCK-8 and thus recognizes biologically active forms of all CCKs. The volume of the gallbladder was calculated by ultrasonographic measurements. Intravenous infusion of Moripron at the rate of 3.33 ml/min for 60 min, caused gallbladder contraction, with a peak response of 31.3 +/- 8.6% of the fasting volume at 45-60 min, and a significant increase in plasma CCK concentration, from 1.8 +/- 0.2 pmol/l to a peak of 9.9 +/- 1.5 pmol/l, at 30-45 min. The maximum gallbladder contraction and the peak CCK release during the Moripron infusion were not significantly different from findings after a test meal. There was a close relationship between the peak plasma CCK concentration and the maximal gallbladder contraction during the administration of Moripron, and this agent, even when infused at the rate of 1.67 ml/min, significantly increased plasma CCK levels and gallbladder contraction. Intravenous infusion of Morihepamin had no significant influence on gallbladder volume or plasma CCK levels. The discrepancy in responses appeared to be related to differences in composition between Moripron and Morihepamin, and not to the total dose of amino acid. Intravenous infusions of amino acids appear to have different effects on gallbladder contraction and plasma CCK secretion depending on the amino acids composition. Our findings suggest that an intravenous infusion of Moripron could be used for the prophylaxis of acute acalculous cholecystitis and sludge formation due to reduced biliary motility in patients on total parenteral nutrition.
我们研究了静脉输注治疗用氨基酸溶液Moripron和Morihepamin(日本大阪乐沙定制药株式会社)对健康男性志愿者胆囊收缩及胆囊收缩素(CCK)释放的影响。采用放射免疫分析法,使用抗体OAL - 656测定血浆CCK水平,该抗体对CCK - 8的氨基末端具有特异性,因此可识别所有CCK的生物活性形式。通过超声测量计算胆囊体积。以3.33 ml/min的速率静脉输注Moripron 60分钟,可引起胆囊收缩,在45 - 60分钟时峰值反应为空腹体积的31.3±8.6%,血浆CCK浓度显著升高,在30 - 45分钟时从1.8±0.2 pmol/l升至峰值9.9±1.5 pmol/l。Moripron输注期间的最大胆囊收缩和CCK释放峰值与试餐后的结果无显著差异。在输注Moripron期间,血浆CCK浓度峰值与最大胆囊收缩之间存在密切关系,即使以1.67 ml/min的速率输注该药物,也可显著提高血浆CCK水平和胆囊收缩。静脉输注Morihepamin对胆囊体积或血浆CCK水平无显著影响。反应差异似乎与Moripron和Morihepamin的成分差异有关,而非氨基酸的总剂量。静脉输注氨基酸似乎根据氨基酸组成对胆囊收缩和血浆CCK分泌有不同影响。我们的研究结果表明,静脉输注Moripron可用于预防全胃肠外营养患者因胆汁动力降低导致的急性非结石性胆囊炎和胆泥形成。