生长抑素类似物对Oddi括约肌肌电活动的双向调节作用及其临床意义

目的 探讨生长激素类似物善得定(sandostatin SS)对Oddi括约肌(Sphincter of oddi,SO)肌电活动的双向调节作用及其临床意义.方法 40只空腹18h成年健康家兔随机分为5组,即静脉注射生理盐水组;皮下注射生理盐水组;小剂量静脉滴注SS组;大剂量皮下注射SS组;静脉注射654-2后小剂量静脉滴注SS组.两对钩状双极金属电极分别置于乳头及十二指肠浆膜下,使用RM6240多道生理仪及信号采集处理系统,实验在PBG-1型生理实验屏蔽柜内进行.连续记录SO肌电活动120～150min.结果 对照第一、第二组用药前后SO肌电活动无明显变化,仍表现为单发、规律的SO锋电位(spike potentials of SO,SPSO);小剂量静脉滴注SS组给药后2～3min出现规律、间断的SO肌电簇(myoelectronic activity of SO,MASO);大剂量皮下注射SS组给药后2～3min,SO肌电活动消失,进入抑制状态;静脉注射654-2后小剂量静脉滴注SS,SPSO和MASO均不复出现.结论 高浓度的SS可以抑制SO肌电活动,导致SO处于舒张状态;而低浓度维持剂量的SS可以使SO肌电活动处于兴奋状态,导致SO蠕动加快;阻断乙酰胆碱能神经可以消除SS对SO肌电活动的兴奋作用.     

奥曲肽对oddi括约肌肌电活动的影响

目的　探讨奥曲肽 (sandostatin ,SS)对oddi括约肌 (sphincterofoddi,SO)肌电活动的影响及其临床意义。方法　 32只空腹 18h成年健康家兔随机分为 4组 ,即静脉注射生理盐水组 ;皮下注射生理盐水组 ;小剂量静脉滴注SS组 ;大剂量皮下注射SS组。两对钩状双极金属电极分别置于乳头及十二指肠浆膜下 ,使用成都仪器厂RM6 2 4 0多道生理仪及信号采集处理系统 ,实验在PBG 1型生理实验屏蔽柜内进行。连续记录SO肌电活动 12 0～ 15 0min。结果　对照第 1组、第 2组用药前后SO肌电活动无明显变化 ,仍表现为单发、规律的SO锋电位 (spikepotentialsofSO ,SPSO) ;小剂量静脉滴注SS组给药后 2～ 3min出现规律、间断的SO肌电簇 (myoelectronicactivityofSO ,MASO) ;大剂量皮下注射SS组给药后 2～ 3min ,SO肌电活动消失 ,进入抑制状态。结论　高浓度的SS可以抑制SO肌电活动 ,导致SO处于舒张状态 ;而低浓度维持剂量的SS可以使SO肌电活动处于兴奋状态 ,导致SO蠕动加快     

奥曲肽对oddi括约肌肌电活动的影响

目的 探讨奥曲肽(sandostatin，SS)对oddi括约肌(sphincter of oddi，SO)肌电活动的影响及其临床意义。方法 32只空腹18h成年健康家免随机分为4组，即静脉注射生理盐水组；皮下注射生理盐水组；小剂量静脉滴注SS组；大剂量皮下注射SS组。两对钩状双极金属电极分别置于乳头及十二指肠浆膜下，使用成都仪器厂RM6240多道生理仪及信号采集处理系统，实验在PBG-1型生理实验屏蔽柜内进行。连续记录SO肌电活动120～150min。结果 对照第1组、第2组用药前后SO肌电活动无明显变化，仍表现为单发、规律的SO锋电位(spike potentials of SO，SPSO)；小剂量静脉滴注SS组给药后2～3min出现规律、间断的SO肌电簇(myoelectronic acfivity of SO，MASO)；大剂量皮下注射SS组给药后2～3min，SO肌电活动消失，进入抑制状态。结论 高浓度的SS可以抑制SO肌电活动，导致SO处于舒张状态；而低浓度维持剂量的SS可以使SO肌电活动处于兴奋状态，导致SO蠕动加快。     

黏膜接触电极在家兔Oddi括约肌肌电测量中的应用价值

目的 探讨适合Oddi括约肌（sphincter of Oddi,SO）肌电测量的新方法.方法 两组各15只家兔分别用黏膜接触电极（contact electrode on mucosa,CEM）和浆膜钩状电极（chorion claw electrode,CCE）测量SO肌电活动;另外6只家兔同时使用两种电极同步测量.结果 CEM测量SO肌电成功率高,创伤小,而且记录到的家兔SO肌电波形和CCE相比没有明显的差别.结论 CEM是一种很有价值的测量SO肌电活动的新方法,将来可能用于人体SO功能的研究,为人体内镜诊断SO功能提供了一个新方法.     

Oddi括约肌功能异常在兔肝内胆管结石形成中的作用

目的 探讨Oddi括约肌(Sphincter of Oddi,SO)功能异常与肝内胆管结石形成的关系.方法 建立家兔肝内胆管结石模型;;成年家兔(n=64)随机分为对照组(n=16)和实验组(n=48),实验组再分为2周,4周,8周组(每组n=16),比较各组胆汁性状及成石率,测定s0肌电,透射电镜观察SO超微结构.结果 8周组家兔成形结石形成率(68.75%,11/16)显著高于4周组(12.50%,2/16)和2周组(0.00%,0/16);肌电测定提示:与对照组比较,实验组SO肌电峰值逐渐减低,频率逐渐减慢.电镜超微结构表现:对照组及2周组SO无变性;实验组4周和8周组SO肌纤维溶解、胶原增多,微丝融合、增粗,致密斑减少、排列紊乱,线粒体、内质网肿胀,核周间隙增宽、核偏移及核固缩,胞质中髓样包涵体形成.其变性程度8周组＞4周组.结论 SO运动功能异常与肝内胆管结石形成存在密切联系,两者互为因果.SO肌纤维变性是其运动功能异常的病理基础.     

胆囊切除术对家兔Oddi括约肌运动功能的影响

目的探讨胆囊切除术对家兔Oddi括约肌运动功能变化的影响。方法将16只成年家兔随机分成正常对照组、胆囊切除术组,每组8只。手术4周后进行Oddi括约肌压力及肌电的同时测定。结果压力测定:胆囊切除术组胆总管压力降低,Oddi括约肌基础压、收缩波幅升高(P<0.01);肌电测定:肌电活动由原来的锋电位变为肌电簇,波幅升高,持续时间延长(P<0.01),收缩频率未见明显变化。结论胆囊切除术后家兔Oddi括约肌功能有明显改变;Oddi括约肌蠕动增强以加快胆汁的排泄。     

犬Oddi括约肌肌电的研究

目的探索能准确稳定记录犬Oddi括约肌(sphincter of Oddi,SO)肌电活动的新方法,并对记录到的肌电波形进行初步分析。方法用自行研制的黏膜接触式电极记录30只犬SO肌电活动,同时记录十二指肠和胃的肌电活动,分析SO肌电波形的规律以及和胃十二指肠肌电的关系。结果用我们的方法可以记录到犬SO的快波和慢波,同步记录以及切离实验证实记录到的波形是犬的SO肌电而不是来自十二指肠和胃。结论犬的SO肌电记录是可行的,犬SO快波和慢波的发现将对SO功能研究提供一个新的平台。     

高胆固醇血症对家兔Oddi括约肌功能的影响

目的 探讨高胆固醇血症对家兔Oddi括约肌运动功能的影响.方法 将32只家兔分为对照组和高胆固醇血症4、6、10周组,每组8只,进行Oddi括约肌压力及肌电的测定.采用t检验对结果进行分析.结果 高胆固醇血症10周组与对照组比较,血清总胆固醇和低密度脂蛋白含量较高(t=9.63,11.38,P<0.05);Oddi括约肌基础压、峰压、振幅升高(t=5.23,6.34,3.24,P<0.05);肌电活动由原来的锋电位变为肌电簇,肌电簇持续时间延长,每簇放电率降低(t=13.68,10.18,P<0.05).结论 家兔发生高胆固醇血症时,胆汁成分发生改变,提高了Oddi括约肌的张力,同时加快Oddi括约肌蠕动,加速胆汁的排泄.     

同步检测胆囊及Oddi氏括约肌电活动和胆管压力的兔模型

目的 建立同步检测胆囊及Oddi括约肌肌电活动及胆囊、胆总管压力的动物模型.方法 对6只家兔用7F静脉深穿管分别经肝穿刺进入胆囊腔及经十二指肠腔插入胆总管.将铂金电极缝在胆囊底部浆膜上.以多通道生理仪记录家兔的胆囊及Oddi括约肌肌电信号和胆囊、胆总管压力.结果 Oddi氏括约肌肌电的峰电位＞0.05 mV,最大电位为0.26 mV,频率为0～2次/分;而慢波电位≤0.05 mV,频率为8⒍11次/分.胆囊内压力最大为15 cm H2O(6.83～15.00 cm H2O),胆总管最大压力为22 cm H2O(11～22 cm H2O).胆囊肌电活动的波形缺乏规律性.结论 兔可以作为同步检测胆囊及Oddi氏括约肌肌电活动和胆囊、胆总管压力的模型.     

研究Oddi括约肌肌电活动的实验动物模型的建立

目的探讨将家兔用于研究Oddi括约肌肌电活动的实验动物模型的可行性和稳定性。方法对不同条件下的家兔采用双极金属钩状电极采集其肌电活动信号，经放大、滤波及计算机处理后记录其大小及波形。结果不同条件下的家兔Oddi括约肌的肌电活动在波形、频率、强度等方面均有明显的不同，具有明显的规律性。重复实验可得到相同的结论。结论家兔是研究Oddi括约肌肌电活动较为理想的动物，具有价格低廉、来源广泛、信号稳定等优点。使用双极金属钩状电极可以稳定地采集到在体的Oddi括约肌肌电活动信号，这为今后广泛、深入地研究Oddi括约肌肌电活动搭建了一个技术平台。     

Effect of alcohol on cyclical myoelectric activity of the opossum sphincter of Oddi

Ethyl alcohol may adversely affect pancreatic function by perturbing sphincter of Oddi (SO) or duodenal motor activity. The aim of this study was to identify the effect of ingested alcohol on the SO, duodenal, and gastric myoelectric activity in conscious opossums. In five adult opossums bipolar stranded stainless-steel wire electrodes were implanted on the SO, gastric antrum, and duodenum. After a 2-week recovery period, each animal underwent eight 8-hr recording sessions while fasted and awake. After two fasting cycles of the migrating myoelectric complex, animals were randomly fed either 10 ml of a 30% ethyl alcohol solution or 10 ml of water via an esophageal tube, and recordings continued for 4-6 hr. During the control state, cyclical myoelectric spike activity was recorded from the SO, gastric antrum, and duodenum with a mean +/- SD cycle length of 7.35 +/- 15.0 min, 74.3 +/- 10.1 min, and 94.8 +/- 8.7 min, respectively. With alcohol, SO and duodenal cycle lengths were unchanged while gastric cycle length decreased. However, alcohol effected a significant increase in peak SO spike burst frequency with no corresponding change in gastric or duodenal spike burst frequency. An equivalent volume of water had no influence on sphincter of Oddi myoelectric activity. It is concluded that ingested alcohol induces increased myoelectric activity from the opossum SO, independent of changes in activity of the duodenum or stomach. Since the SO plays a major role in metering bile and pancreatic flow into the duodenum, this may be a factor in alcohol-induced pancreatitis.     

A new method for correlating pancreatic and biliary duct pressures and sphincter of Oddi electromyography

Myoelectric activity of the sphincter of Oddi and duodenum was correlated with pancreatic and biliary duct pressures in eight opossums, in both the fasted and fed states. Four bipolar electrode pairs were implanted in the sphincter of Oddi and duodenum. A polyethylene T tube was placed in the pancreatic duct. The common duct was cannulated through a small bile duct. This method allowed pressure recording for several weeks and avoided interference with the flow of bile or pancreatic juice into the duodenum. The frequency of slow waves was the same in the sphincter of Oddi and duodenum (19 per minute). The variation in the frequency of spike potentials in the sphincter of Oddi correlated to that of the migrating myoelectric complex in the duodenum. The average frequency of slow waves that have superimposed spike potentials in the sphincter of Oddi and duodenum was 3.0 and 0 in phase 1, 4.7, and 6.2 in phase II, 6.1 and 15.1 in phase III, and 3.4 and 6.3 in phase IV, respectively. The average duration of a migrating myoelectric complex cycle was 92 minutes. After feeding, the interdigestive phases of the migrating myoelectric complex were abolished and substituted by a feeding activity pattern that was characterized by an average number of sphincter of Oddi and duodenum spikes of 6.6 and 10.7, respectively. The mean fasting pressure in the pancreatic and biliary duct was 15 and 13 mmHg, respectively. Pressure changes were of two types--synchronous with respiratory movements and with each sphincter of Oddi spike potential. There was no variation in the baseline pressure during the migrating myoelectric complex phases and the fed state. It is concluded that the sphincter of Oddi of the fasting opossum exhibits cyclic changes in the number of spike potentials that correlate with the migrating myoelectric complex in the duodenum. However, the number and amplitude of spike potentials are different in the sphincter of Oddi and duodenum. There is no change in the baseline pressure during fasting and feeding states, and a temporary pressure elevation synchronic with each sphincter of Oddi spike potential was observed.     

豚鼠不全性胆道梗阻早期Oddi括约肌功能的变化

目的:观察豚鼠胆道不全性梗阻后早期Oddi括约肌(SO)肌电活动及压力的变化。方法:16只英国短毛豚鼠随机均分假手术组与模型组,分别行假手术与制作胆总管不全性梗阻模型,期间测定胆总管直径;术后1周,再次检测两组胆总管直径、肝功能指标、SO肌电活动与动力学指标。结果:术后假手术组胆总管直径无明显改变(P0.05),而模型组较术前明显增大(P0.05)。与假手术组比较,模型组血清胆红素、肝酶水平明显升高(均P0.05);SO快波幅度和慢波振幅显著降低(均P0.05),但快波和慢波频率无统计学差异(均P0.05);SO基础压明显升高,但SO峰压明显降低(均P0.05),而SO收缩频率无统计学差异(P0.05)。结论:不全性胆总管梗阻可使豚鼠SO快、慢波振幅降低,SO基础压升高、收缩峰压降低,这可能是胆道不全性梗阻时易诱发急性胆源性胰腺炎的重要机制之一。     

十二指肠对奥狄氏括约肌运动的调节

目的 通过观察清醒状态下十二指肠切除后狗奥狄氏括约肌(SO)运动的变化，检验十二指肠对SO运动的调节作用。方法对照组(n=6)于十二指肠乳头对侧植入测量用套管。十二指肠切除组(n=6)保留十二指肠乳头切除十二指肠，将近端空肠(重建十二指肠)与胃吻合，原十二指肠乳头与重建十二指肠行端侧吻合，再于吻合后的十二指肠乳头对侧植入测量用套管。经套管插入测压管，通过压力变化来观测SO及十二指肠运动变化。结果十二指肠切除后，SO周期性运动消失，SO呈持续性强收缩状态。结论十二指肠对消化间期SO运动有重要的调节作用。     

Advances in research and clinical practice in motor disorders of the sphincter of Oddi

Perfusion manometry of the sphincter of Oddi (SO) using a pneumohydraulic capillary infusion system records phasic wave activity superimposed on basal pressure. A triple-lumen catheter allows the recording of propagation of the phasic waves. Microtransducer manometry is an alternative that permits prolonged recording of biliary pressure without the need for infusion. A cyclic change is recognized in SO motility in coordination with the migrating motor complex (MMC) of the duodenum during fasting. SO contractions occur at maximal frequency and amplitude during phase 3 of the duodenal MMC. Using two microtransducer catheters placed by duodenoscopy, a cyclic elevation of biliary pressure can be recorded in concert with phase 3. These findings indicate that human SO contractions impede bile flow. SO dysfunction causing biliary-type pain can be diagnosed by manometry. The pressure elevation during phase 3 may contribute to the development of pain in patients with biliary dyskinesia. Gastrectomy and proximal duodenal transection were proven to affect sphincter motility, as evidenced by the paradoxical response to cholecystokinin. Choledocholithiasis and hepatolithiasis are associated with low basal pressure, presumably due to repeated injury to the sphincter by passing stones. SO and biliary manometry leads to better understanding of biliary dynamics and the pathophysiology of biliary diseases. Received: March 25, 2002 / Accepted: April 14, 2002 Offprint requests to: M. Tanaka