AIM: To detect whether patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux by measuring the radioactivity of Tc99m-labeled diethylene triamine penta-acetic acid (DTPA) in the b...AIM: To detect whether patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux by measuring the radioactivity of Tc99m-labeled diethylene triamine penta-acetic acid (DTPA) in the bile and whether the patients with duodenal-biliary reflux have sphincter of Oddi hypomotility, by mea-suring the level of plasma and serum gastrin of the patients. Finally to if there is close relationship among sphincter of Oddi hypomotility, duodenal-biliary reflux and gastrointestinal peptides. METHODS: Forty-five patients with a T tube after cholecystectomy and choledochotomy were divided into reflux group and control group. The level of plasma and serum gastrin of the patients and of 12 healthy volunteers were measured by radioimmunoas-say. Thirty-four were selected randomly to undergo choledochoscope manometry. Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of con-tractions (SOF), duration of contractions (SOD), duo-denal pressure (DP) and common bile duct pressure (CBDP) were scored and analyzed. RESULTS: Sixteen (35.6%) patients were detected to have duodenal-biliary reflux. SOBP, SOCA and CBDP in the reflux group were much lower than the controlgroup (t = 5.254, 3.438 and 3.527, P < 0.001). SOD of the reflux group was shorter than the control group (t = 2.049, P < 0.05). The level of serum gastrin and plasma motilin of the reflux group was much lower than the control group (t = -2.230 and -2.235, P < 0.05). There was positive correlation between the level of plasma motilin and SOBP and between the level of serum gastrin and SOBP and CBDP. CONCLUSION: About 35.9% of the patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux. Most of them have sphincter of Oddi hypomotility and the decreased level of plasma motilin and serum gastrin. The disorder of gastroin-testinal hormone secretion may result in sphincter of Oddi dysfunction. There is a close relationship between sphincter of Oddi hypomotility and duodenal-biliary re-flux.展开更多
目的探讨脾虚证大鼠 IMC-胃肠运动-Mot 含量间的关系,为脾虚证本质提供客观依据.方法用传感器和双极银丝电极同步、动态地观察7 d 和14 d 脾虚证(pixu)大鼠胃和十二指肠消化间期综合肌电(IMC)电活动的及其机械运动,以及用放射免疫分析法...目的探讨脾虚证大鼠 IMC-胃肠运动-Mot 含量间的关系,为脾虚证本质提供客观依据.方法用传感器和双极银丝电极同步、动态地观察7 d 和14 d 脾虚证(pixu)大鼠胃和十二指肠消化间期综合肌电(IMC)电活动的及其机械运动,以及用放射免疫分析法(RIA)分析下丘脑、胃窦、十二指肠组织及血浆中的胃动素(Mot)的含量.结果与对照组比较,脾虚早期十二指肠Ⅰ相时程缩短(1.9±0.7 vs 4.2±0.3 min),Ⅱ相时程延长(6.5±0.4 vs 4.3±0.7min),脾虚晚期十二指肠Ⅱ相时程缩短(1.1±0.3 min).脾虚早期十二指肠收缩振幅(103.5±9.7 vs 78.9±6.3 mV/min)和收缩频率(21.4±1.9 vs 17.3±0.9次/min)均明显高于正常大鼠,而脾虚晚期表现为十二指肠收缩振幅(106.9±10.3mV/min)明显高于正常大鼠,收缩频率(11.7±1.2次/min)则明显减低.无论脾虚早期或晚期胃 IMC Ⅰ相时程延长(8.2±0.9和6.2±1.1 vs 3.5±0.8 min,运动功能均减弱(9.2±1.8和5.2±0.2 vs 13.4±1.3次/min,75.2±10.1和42.4±9.1vs 110.2±9.8mV/min).脾虚早期下丘脑、胃窦、十二指肠、空肠组织及血浆中 Mot 的含量升高(76.4±8.0,37.2±7.3.51.2±1.9,63.2±2.2和99.8±6.5 vs 53.2±9.3,29.5±7.6,35.6±3.0,46.6±7.0和82.7±9.3 ng/L),而脾虚晚期却下降(32.5±5.5,21.6±6.2,27.9±1.7,32.3±5.1和64.5±5.4 ng/L,P<0.05～P<0.01).结论脾虚程度不同,其各部位的 Mot 含量,十二指肠 IMC 的Ⅰ,Ⅱ相持续时间及机械运动不同;脾虚时 IMC 十二指肠运动-Mot 含量间存在正相关关系(r=0.9937),而 IMC 一胃运动-Mot 含量间为负相关关系(r=-0.9986).此体现了脾虚证在发展过程中由轻到重、由初期到久病的不同阶段,为认识脾虚证提供了定性定量客观依据.展开更多
文摘AIM: To detect whether patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux by measuring the radioactivity of Tc99m-labeled diethylene triamine penta-acetic acid (DTPA) in the bile and whether the patients with duodenal-biliary reflux have sphincter of Oddi hypomotility, by mea-suring the level of plasma and serum gastrin of the patients. Finally to if there is close relationship among sphincter of Oddi hypomotility, duodenal-biliary reflux and gastrointestinal peptides. METHODS: Forty-five patients with a T tube after cholecystectomy and choledochotomy were divided into reflux group and control group. The level of plasma and serum gastrin of the patients and of 12 healthy volunteers were measured by radioimmunoas-say. Thirty-four were selected randomly to undergo choledochoscope manometry. Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of con-tractions (SOF), duration of contractions (SOD), duo-denal pressure (DP) and common bile duct pressure (CBDP) were scored and analyzed. RESULTS: Sixteen (35.6%) patients were detected to have duodenal-biliary reflux. SOBP, SOCA and CBDP in the reflux group were much lower than the controlgroup (t = 5.254, 3.438 and 3.527, P < 0.001). SOD of the reflux group was shorter than the control group (t = 2.049, P < 0.05). The level of serum gastrin and plasma motilin of the reflux group was much lower than the control group (t = -2.230 and -2.235, P < 0.05). There was positive correlation between the level of plasma motilin and SOBP and between the level of serum gastrin and SOBP and CBDP. CONCLUSION: About 35.9% of the patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux. Most of them have sphincter of Oddi hypomotility and the decreased level of plasma motilin and serum gastrin. The disorder of gastroin-testinal hormone secretion may result in sphincter of Oddi dysfunction. There is a close relationship between sphincter of Oddi hypomotility and duodenal-biliary re-flux.
文摘目的探讨脾虚证大鼠 IMC-胃肠运动-Mot 含量间的关系,为脾虚证本质提供客观依据.方法用传感器和双极银丝电极同步、动态地观察7 d 和14 d 脾虚证(pixu)大鼠胃和十二指肠消化间期综合肌电(IMC)电活动的及其机械运动,以及用放射免疫分析法(RIA)分析下丘脑、胃窦、十二指肠组织及血浆中的胃动素(Mot)的含量.结果与对照组比较,脾虚早期十二指肠Ⅰ相时程缩短(1.9±0.7 vs 4.2±0.3 min),Ⅱ相时程延长(6.5±0.4 vs 4.3±0.7min),脾虚晚期十二指肠Ⅱ相时程缩短(1.1±0.3 min).脾虚早期十二指肠收缩振幅(103.5±9.7 vs 78.9±6.3 mV/min)和收缩频率(21.4±1.9 vs 17.3±0.9次/min)均明显高于正常大鼠,而脾虚晚期表现为十二指肠收缩振幅(106.9±10.3mV/min)明显高于正常大鼠,收缩频率(11.7±1.2次/min)则明显减低.无论脾虚早期或晚期胃 IMC Ⅰ相时程延长(8.2±0.9和6.2±1.1 vs 3.5±0.8 min,运动功能均减弱(9.2±1.8和5.2±0.2 vs 13.4±1.3次/min,75.2±10.1和42.4±9.1vs 110.2±9.8mV/min).脾虚早期下丘脑、胃窦、十二指肠、空肠组织及血浆中 Mot 的含量升高(76.4±8.0,37.2±7.3.51.2±1.9,63.2±2.2和99.8±6.5 vs 53.2±9.3,29.5±7.6,35.6±3.0,46.6±7.0和82.7±9.3 ng/L),而脾虚晚期却下降(32.5±5.5,21.6±6.2,27.9±1.7,32.3±5.1和64.5±5.4 ng/L,P<0.05～P<0.01).结论脾虚程度不同,其各部位的 Mot 含量,十二指肠 IMC 的Ⅰ,Ⅱ相持续时间及机械运动不同;脾虚时 IMC 十二指肠运动-Mot 含量间存在正相关关系(r=0.9937),而 IMC 一胃运动-Mot 含量间为负相关关系(r=-0.9986).此体现了脾虚证在发展过程中由轻到重、由初期到久病的不同阶段,为认识脾虚证提供了定性定量客观依据.
