Castedal M, Björnsson E, Abrahamsson H
Dept. of Internal Medicine, Sahlgrenska University Hospital, Göteborg,Sweden.
Scand J Gastroenterol. 1997 Aug;32(8):797-804. doi: 10.3109/00365529708996537.
The last part of phase III of the migrating motor complex (MMC) is characterized by retroperistalsis in the descending duodenum. This study focused on MMC-related juxtapyloric peristalsis.
Antroduodenal manometry was performed in 10 healthy subjects. Pressure was recorded in the distal antrum and in four consecutive subsegments (DS1-DS4), 15 mm each, in the juxtapyloric duodenum.
In the period with ongoing antral phase-III activity (early duodenal phase III) the antral pressure waves were antegrade, but in the juxtapyloric duodenum (DS1) retrograde waves predominated (median, 66%; interquartile range (IQR), 33-83%); that is, most duodenal pressure waves were directed against the antral ones. More distally, in DS3 and DS4, only 17% and 25% (IQR, 0-17, 0-33%, respectively) of the pressure waves were retrograde in this period. After the end of antral phase III--that is, in late duodenal phase III--the proportion of retrograde pressure waves increased successively to 91.5% (IQR, 66-100%) in DS2, 74.5% (IQR, 50-100%) in DS3, and 66% (IQR, 8.2-95.8%) in DS4, respectively, before the onset of duodenal motor quiescence. In phase II antegrade pressure waves predominated (63-76%, medians) in all four duodenal subsegments examined.
During the interdigestive phase III the antral perstalsis is antegrade, but most juxtapyloric duodenal pressure waves are retrograde; that is, antral and duodenal contractions are on a collision course. In the proximal part of the descending duodenum the end of duodenal phase III shows retroperistalsis after the onset of phase I in the gastric antrum. These motor patterns may be important for regulation of the chemical milieu in the juxtapyloric area.
移行性复合运动（MMC）第三阶段的最后部分，其特征是十二指肠降段出现逆蠕动。本研究聚焦于与MMC相关的幽门旁蠕动。
对10名健康受试者进行十二指肠测压。在幽门旁十二指肠的远端胃窦和四个连续的子段（DS1-DS4，每个子段15毫米）记录压力。
在胃窦第三阶段活动持续期间（十二指肠早期第三阶段），胃窦压力波是顺行的，但在幽门旁十二指肠（DS1）逆行波占主导（中位数为66%；四分位间距（IQR）为33%-83%）；也就是说，大多数十二指肠压力波与胃窦压力波方向相反。在更远处的DS3和DS4，在此期间只有17%和25%（IQR分别为0%-17%、0%-33%）的压力波是逆行的。在胃窦第三阶段结束后，即十二指肠晚期第三阶段，逆行压力波的比例在十二指肠运动静止开始前，在DS2中依次增加到91.5%（IQR为66%-100%），在DS3中为74.5%（IQR为50%-100%），在DS4中为66%（IQR为8.2%-95.8%）。在第二阶段，在所检查的所有四个十二指肠子段中，顺行压力波占主导（中位数为63%-76%）。
在消化间期第三阶段，胃窦蠕动是顺行的，但大多数幽门旁十二指肠压力波是逆行的；也就是说，胃窦和十二指肠收缩呈碰撞状态。在十二指肠降段近端，十二指肠第三阶段结束时，在胃窦第一阶段开始后出现逆蠕动。这些运动模式可能对调节幽门旁区域的化学环境很重要。
