胃肠激素与十二指肠胃反流及消化间期胃肠移行性复合运动的关系

目的　探讨胃肠激素与生理性十二指肠胃反流 (DGR)及胃肠消化间期移行性复合运动 (MMC)的关系。方法　选择健康志愿者 2 0例 ,进行 2 4h胃内 pH和胃内胆汁监测 ;采用灌注式测压法进行长时夜间胃窦十二指肠压力测定 ;分别于碱反流、胆汁反流发生前后及胃窦十二指肠MMC各时相抽血 ,检测胃动素 (MTL)、P物质 (SP)、生长抑素(SS)、一氧化氮 (NO)的水平。结果　碱反流和胆汁反流发生时与未发生时比较 ,血中NO的浓度明显增高 ,分别为(98.2 3± 12 .14 ) μmol·L-1和 (71.2 4± 10 .2 1) μmol·L-1(P <0 .0 1) ;(87.32± 11.4 6 ) μmol·L-1和 (6 9.4 5± 10 .5 6 ) μmol·L-1(P <0 .0 5 ) ;血浆中MTL、SP、SS的浓度无显著性差异。血浆MTL浓度在胃窦MMCⅢ相时为 (32 9.5 6± 4 7.2 8)ng·L-1,比MMCⅠ相 (2 37.4 3± 4 1.5 4 )ng·L-1和MMCⅡ相 (2 5 6 .5 6± 4 4 .32 )ng·L-1显著增高 (P均 <0 .0 5 )。SP、SS、和NO在MMC各相无显著差异。结论　DGR的发生与NO浓度改变有关 ;MTL与MMCⅢ相的发生有关。

Relationship of gastrointestinal hormone with duodenogastric reflux and interdigestive antroduodenal migrating moter complex

Objective To study the relationship of gastrointestinal hormone with duodenogastric reflux (DGR) and interdigestive antroduodenal migrating moter complex(MMC). Methods Antroduodenal manometry, simultaneous 24-hour intragastric pH and Bilitec monitoring were carried out in 20 healthy volunteers overnight for a long time. Blood samples were drawn at episodes of alkaline reflux and/or bile reflux, and after reflux, as well as at interdigestive MMC phase Ⅰ,Ⅱ and Ⅲ, respectively and were detected for motilin, substance P, somatostatin and nitric oxide. Results The serum concentration of NO was significantly increased during alkaline reflux \(98.23±12.14)μmol·L -1and (71.24±10.21)μmol·L -1,P<0.01\] and bile reflux \(87.32±11.46)μmol·L -1 and (69.45±10.56)μmol·L -1,P<0.05\] compared to no episodes of DGR. The concentrations of MTL, SP and SS were not different between alkaline or bile reflux and no episodes of DGR. The plasma concentration of MTL was higher in phase Ⅲ than in phase Ⅰ(P<0.05) and phase Ⅱ( P<0.05). The concentrations of SP, SS and NO did not differ among each phase of MMC. Conclusion DGR may be related to increased concentration of NO, and MMC phase Ⅲ is related to the concentration of MTL.