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肝硬化患者的胃动力异常:促胰液素的作用

Abnormal gastric motility in liver cirrhosis: roles of secretin.

作者信息

Usami A, Mizukami Y, Onji M

机构信息

Third Department of Internal Medicine, Ehime University School of Medicine, Japan.

出版信息

Dig Dis Sci. 1998 Nov;43(11):2392-7. doi: 10.1023/a:1026613711375.

Abstract

Cutaneous electrogastrography (EGG) revealed that the power ratio, an indicator of rhythmicity of EGG waveforms was significantly less in liver cirrhosis (power ratio: 28.2+/-14.5%) than in normal subjects (power ratio: 45.6+/-16.2%) (P < 0.01), thus demonstrating dysrhythmic EGG waveforms for liver cirrhosis. Gastric emptying time (T1/2), calculated from the half-life of retained radioisotope (RI) in the region of interest (ROI) in the stomach following the ingestion of RI containing test meal was significantly prolonged in patients with liver cirrhosis compared to the control (liver cirrhosis vs controls 43.2+/-20.3 min vs 24.8+/-9.6 min, P < 0.01). Of the five gastrointestinal hormones-gastrin, secretin, motilin, cholecystokinin (CCK), and glucagon-serum secretin was significantly higher in liver cirrhosis than the control (P < 0.05) and negatively correlated with the power ratio (r = 0.51, P < 0.01). Normal, regular EGG waveforms (power ratio: 47.1+/-10.2%) became dysrhythmic in normal volunteers (power ratio: 34.1+/-12.4%), when their serum secretin was experimentally increased to essentially that in liver cirrhosis and possible roles of hypersecretinemia in abnormal gastric motility in liver cirrhosis are proposed.

摘要

皮肤胃电图(EGG)显示,作为EGG波形节律性指标的功率比在肝硬化患者中(功率比:28.2±14.5%)显著低于正常受试者(功率比:45.6±16.2%)(P<0.01),从而证明肝硬化患者的EGG波形存在节律异常。肝硬化患者摄入含放射性同位素(RI)的试验餐之后,根据胃内感兴趣区域(ROI)中保留RI的半衰期计算出的胃排空时间(T1/2)与对照组相比显著延长(肝硬化组与对照组分别为43.2±20.3分钟和24.8±9.6分钟,P<0.01)。在胃泌素、促胰液素、胃动素、胆囊收缩素(CCK)和胰高血糖素这五种胃肠激素中,肝硬化患者血清促胰液素显著高于对照组(P<0.05),且与功率比呈负相关(r = 0.51,P<0.01)。当正常志愿者的血清促胰液素通过实验升高至肝硬化患者的水平时,正常、规则的EGG波形(功率比:47.1±10.2%)变为节律异常(功率比:34.1±12.4%),并提出高促胰液素血症在肝硬化患者胃动力异常中的可能作用。

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