无创地记录胃十二指肠的肠蠕动活动(实验和临床研究)。

E Atanassova, B Damianov, P Gurkov, V Kolev
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摘要

健康志愿者和恶心呕吐患者的胃和小肠上部的电活动在原始胃电图上无创记录。根据其振幅区分出两种波:低振幅波,对应于迁移肌电复合体(MMC)的静止期;振幅高约两倍的波,表征MMC(蠕动活动)的活动期。来自小肠的低振幅波和高振幅波之间也存在一些差异。从胃记录的高振幅波序列之后通常是从小肠记录的高振幅波序列,显示MMC从胃到小肠的一个活跃期的体外扩散。然而,在一些患者中,高振幅波首先从十二指肠记录中被引出,然后在胃记录中出现高振幅波。这表明口腔蠕动活动(反蠕动)扩散。采用胃、十二指肠肌壁长期植入电极,建立大鼠抗蠕动实验模型。5 μ g /kg灌胃氨基戊二醇可诱发先十二指肠慢波后胃慢波的脉冲电位。狗的脉冲活动的反蠕动扩散与人类小肠记录中首先出现的高振幅波相对应,其次是胃中的一系列高振幅波。因此,对胃和小肠电活动的非侵入性记录提供了关于蠕动活动扩散方向的可靠信息。
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Non-invasive registration of the aboral and oral spreading of the gastroduodenal peristaltic activity (experimental and clinical investigations).

The electrical activity of the stomach and the upper part of the small intestine of healthy volunteers and patients with nausea and vomiting was recorded non-invasively on an original electrogastrograph. Two kinds of waves were distinguished according to their amplitude: low-amplitude waves, corresponding to the period of quiescence of migrating myoelectrical complex (MMC) and about twice higher in amplitude waves, characterising the periods of activity of MMC (peristaltic activity). There was also some difference between the low- and high-amplitude waves from the small intestine. Sequence of high-amplitude waves recorded from the stomach was followed usually by sequence of high-amplitude waves from the small intestine, presenting the aboral spreading of an activity period of MMC from the stomach to the small intestine. In some patients however, high-amplitude waves were led off first from the duodenal record and after that high-amplitude waves appeared in the gastric record. This suggests an oral spreading of the peristaltic activity (antiperistalsis). Experimental model of antiperistalsis was performed on dogs with chronically implanted electrodes on the gastric and duodenal muscle wall. Carbachol 5 micrograms/kg i.m. evoked bursts of spike potentials first with duodenal slow waves and after that with the gastric slow potentials. The antiperistaltic spreading of the spike activity in dog corresponded to the appearance of high-amplitude waves first in the record of the human small intestine, followed by sequence of high-amplitude waves in the stomach. Thus, the non-invasive recording of the electrical activity of the stomach and small intestines gives reliable information about the direction of the spreading of the peristaltic activity.

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