Thimister P W, Hopman W P, Rosenbusch G, Jansen J B
Department of Gastroenterology & Hepatology, University Hospital Nijmegen, The Netherlands.
Dig Dis Sci. 1998 Mar;43(3):668-72. doi: 10.1023/a:1018844031460.
Impaired postprandial gallbladder emptying in celiac disease has been attributed to an absence of appropriate cholecystokinin release. To determine if a flat jejunal mucosa in celiac patients is related to a reduced cholecystokinin-secreting capacity, increasing doses of bombesin were infused into six patients with celiac disease and a flat jejunal mucosa (group A), in seven celiac patients with a normal jejunal mucosa while on a gluten-free diet (group B), and in seven healthy controls (group C). Bombesin induced significant (P < 0.05) increments of plasma CCK to a maximum value of 1.0 +/- 0.3 pM in group A, to 1.5 +/- 0.3 pM in group B, and to 1.2 +/- 0.3 pM in group C (NS between groups), that were accompanied by significant (P < 0.05) gallbladder emptying responses of 70 +/- 4% in group A, 47 +/- 10% in group B and 65 +/- 5% in group C. Dose-response relationships were not different between groups. We conclude that there is no major impairment of gallbladder responsiveness to bombesin or of cholecystokinin-secreting capacity in patients with a flat jejunal mucosa due to celiac disease.
乳糜泻患者餐后胆囊排空受损被认为是由于缺乏适当的胆囊收缩素释放。为了确定乳糜泻患者空肠黏膜扁平是否与胆囊收缩素分泌能力降低有关,分别向6例患有乳糜泻且空肠黏膜扁平的患者(A组)、7例无麸质饮食时空肠黏膜正常的乳糜泻患者(B组)和7名健康对照者(C组)输注递增剂量的蛙皮素。蛙皮素使A组血浆胆囊收缩素显著(P<0.05)升高至最大值1.0±0.3 pM,B组为1.5±0.3 pM,C组为1.2±0.3 pM(组间无显著差异),同时A组、B组和C组胆囊排空反应分别显著(P<0.05)升高至70±4%、47±10%和65±5%。组间剂量反应关系无差异。我们得出结论,因乳糜泻导致空肠黏膜扁平的患者,其胆囊对蛙皮素的反应性或胆囊收缩素分泌能力并无重大损害。