Siadati M, Sarr M G
Department of Surgery and Gastroenterology Research Unit, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
J Gastrointest Surg. 1998 Jul-Aug;2(4):363-72. doi: 10.1016/s1091-255x(98)80076-0.
The need for extrinsic neural input to the upper gut in regulation/control of cyclic interdigestive motility and release of motilin remains a topic of controversy. Our aim was to determine whether extrinsic denervation of the upper gut disrupts cyclic release of motilin in relation to the migrating motor complex. Ten dogs underwent transection of all extrinsic innervation and enteric neural input to the stomach, small intestine, colon, pancreas, and liver while enteric neural continuity within this multivisceral complex was maintained. A cyclic pattern of motility occurred during fasting in all dogs in the small bowel (period = 100 +/- 3 min, mean +/- standard error of the mean) and in 8 of 10 dogs in the stomach (period = 98 +/- 4 min). Gastric cycles were temporally coordinated with small bowel cycles. Plasma motilin concentrations cycled temporally with the motility pattern with the greatest concentrations occurring during gastroduodenal phase III-like activity. Exogenous motilin induced a burst of gastric contractions and a premature migrating motor complex in all dogs. Oral meals disrupted cyclic motility and cyclic changes in plasma motilin. Extrinsic innervation to the upper gut is not necessary for cyclic motor activity, for coordinated cyclic release of motilin, or to initiate a premature migrating motor complex-like response to motilin. Central nervous system input (afferent, efferent) is not necessary for cyclic interdigestive activity or cyclic release of motilin.
在上消化道调节/控制周期性消化间期运动及胃动素释放过程中,是否需要外在神经输入仍是一个存在争议的话题。我们的目的是确定上消化道的外在去神经支配是否会破坏与移行性运动复合波相关的胃动素周期性释放。10只犬接受了对胃、小肠、结肠、胰腺和肝脏的所有外在神经支配及肠神经输入的横断,同时维持该多脏器复合体内部的肠神经连续性。所有犬在禁食期间小肠均出现了周期性运动模式(周期 = 100±3分钟,均值±均值标准误),10只犬中有8只胃出现了周期性运动模式(周期 = 98±4分钟)。胃周期与小肠周期在时间上相互协调。血浆胃动素浓度随运动模式呈周期性变化,在类似胃十二指肠III期活动期间浓度最高。外源性胃动素在所有犬中均诱发了一阵胃收缩和一次提前的移行性运动复合波。口服餐食扰乱了周期性运动及血浆胃动素的周期性变化。上消化道的外在神经支配对于周期性运动活动、胃动素的协调周期性释放或引发对胃动素的类似提前移行性运动复合波反应并非必需。中枢神经系统输入(传入、传出)对于周期性消化间期活动或胃动素的周期性释放也并非必需。