Boeckxstaens G E, Horowitz M, Bermingham H, Holloway R H
Division of Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands.
Neurogastroenterol Motil. 1997 Dec;9(4):239-46. doi: 10.1046/j.1365-2982.1997.d01-64.x.
BACKGROUND/AIMS: A marked elevation in the blood glucose concentration (approximately 15 mmol L-1) slows oesophageal peristalsis. Recent studies indicate that changes in blood glucose within the normal postprandial range affect gastric motility and emptying. The aim of this study was to investigate whether such alterations in blood glucose also affect oesophageal motility.
In eight healthy subjects oesophageal motility and sensation to balloon distension were measured on two separate days while blood glucose concentrations were stabilized with an insulin-glucose clamp at 4 mmol L-1 and 8 mmol L-1.
Peristaltic velocity in the proximal oesophagus and over the oesophagus as a whole was faster at a plasma glucose concentration of 8 mmol L-1 compared with those at 4 mmol L-1 (proximal 3.3 +/- 0.3 cm s-1 vs 2.6 +/- 0.2 cm s-1, P < 0.05, total 3.1 +/- 0.2 cm s-1 vs 2.7 +/- 0.2 cm s-1, P < 0.005) but there were no differences in wave amplitude or duration, or basal lower oesophageal sphincter pressure (LOSP). The threshold for initial perception of oesophageal distension was lower at a plasma glucose of 8 mmol L-1 (2.9 +/- 0.5 mL vs 4.9 +/- 1.0 mL, P < 0.05).
physiological variations in plasma glucose concentration influence oesophageal motility and sensation. These observations suggest that in order to minimize effects of varying plasma glucose levels on oesophageal motility, manometry should be performed under the same fasting or fed conditions when oesophageal motor function is evaluated.
背景/目的：血糖浓度显著升高（约15 mmol/L）会减缓食管蠕动。最近的研究表明，正常餐后范围内的血糖变化会影响胃动力和排空。本研究的目的是调查血糖的这种变化是否也会影响食管动力。
在8名健康受试者中，在两天内分别测量食管动力和对气囊扩张的感觉，同时通过胰岛素-葡萄糖钳将血糖浓度稳定在4 mmol/L和8 mmol/L。
与血糖浓度为4 mmol/L时相比，血糖浓度为8 mmol/L时，食管近端和整个食管的蠕动速度更快（近端：3.3±0.3 cm/s对2.6±0.2 cm/s，P<0.05；整体：3.1±0.2 cm/s对2.7±0.2 cm/s，P<0.005），但波幅、持续时间或基础下食管括约肌压力（LOSP）没有差异。在血糖浓度为8 mmol/L时，食管扩张初始感知阈值更低（2.9±0.5 mL对4.9±1.0 mL，P<0.05）。
血浆葡萄糖浓度的生理变化会影响食管动力和感觉。这些观察结果表明，为了尽量减少血浆葡萄糖水平变化对食管动力的影响，在评估食管运动功能时，应在相同的禁食或进食条件下进行测压。
