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背景:胃电刺激(GES)可以调控胃慢波,但其作用机制尚不完全清楚。原癌基因蛋白c—fos的表达可作为神经元功能活动的标志物。目的:以c-fos蛋白的表达为观察指标,探讨GES调控胃肌电慢波的神经机制。方法:将雌性Wistar大鼠随机分为对照组和GES组。GES以控制胃慢波为准,持续1h。分别于刺激后0.5、1、2和5h处死大鼠,以免疫组化方法观察c—fos蛋白在延髓孤束核和迷走神经运动背核中的表达。结果:对照组延髓孤束核和迷走神经运动背核仅见微量c—fos蛋白表达,GES后0.5h其表达开始增强,1h时达高峰,以后逐渐减弱。结论:GES可以调控胃肌电慢波,GES后延髓孤束核和迷走神经运动背核神经元c-fos蛋白表达阳性提示迷走神经可能参与了该调控作用。 相似文献
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胃起搏对胃动力紊乱犬胃排空及胃肌电活动的影响 总被引:9,自引:1,他引:9
目的 研究胃起搏对胃动力紊乱犬胃排空及胃电参数的影响。方法 采用双侧迷走神经干切断术联合应用胰高血糖素建立胃动力紊乱犬模型 ;采用 4导联胃肠电系统微机分析仪记录胃肠浆膜肌电活动 ;99mTc 植酸钠标记的半固体试餐 ,单光子计算机断层显像技术 (SPECT)检测胃半排空时间(GEt1/ 2 ) ;采用适宜起搏参数从胃体、胃窦在腹部投影部位输入起搏信号驱动胃电节律。结果 迷走神经干切断术后犬的GEt1/ 2 为 (79.4 2± 1.91)min ,较术前 (5 6 .35± 2 .99)min明显延迟 (P <0 .0 0 1) ,但行胃起搏治疗后GEt1/ 2 为 (6 4 .94± 1.75 )min ,较治疗前明显加快 (P <0 .0 0 1) ;胃起搏治疗前迷走神经干切断犬餐后的胃电频率为 (0 .0 81± 0 .0 0 7)Hz、胃电幅度为 (2 .32± 0 .35 )mV、慢波的传播速度为 (4 .0 6± 0 .4 0 )cm/s ,均较正常对照犬显著降低 [(0 .0 90± 0 .0 0 6 )Hz ,(4 .2 5± 0 .12 )mV ,(6 .92± 0 .2 4 )cm/s,(P <0 .0 5 ) ],治疗后其餐后胃电频率 (0 .0 92± 0 .0 0 5 )Hz、胃电幅度 (3.97± 0 .19)mV和慢波的传播速度 (5 .5 7± 0 .4 8)cm/s均明显高于治疗前 (P <0 .0 5 )。结论 采用适宜起搏参数输入起搏信号可完全触发胃电慢波 ,改善胃电参数 ,纠正药物导致的异常胃电节律 ,加速胃排空 ,恢 相似文献
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胃起搏对胃动力紊乱犬胃肌电活动和血浆胃动素水平的影响 总被引:9,自引:1,他引:9
背景:胃起搏治疗胃动力紊乱性疾病已引起人们的关注,但其作用机制尚不清楚。目的:研究胃起搏对胃动力紊乱犬胃肌电活动和血浆胃动素水平的影响,观察胃起搏治疗前后胃电参数与血浆胃动素含量的相关性,进而探索胃起搏的作用机制。方法:采用双侧迷走神经干切断术联合应用胰高血搪素建立胃动力紊乱或节律紊乱犬模型。采用4导联胃肠电系统微机分析仪记录胃浆膜肌电活动:采用放射免疫法测定血浆胃动素含量。采用适宜的起搏参数从腹部体表驱动胃电慢波,1次d,每次45min,疗程为30天,均在餐后进行。结果:双侧逃走神经干切断术后,模型犬的餐后胃电主频(4.85 cpm±0.40 cpm)、平均幅度(2.32 mV±0.35 mV)和慢波传播速度(4.06 cm/s±0.40cm/s)均较止常对照犬显著降低(5.37 cpm±0.36 cpm,4.25 mV±0.12 mV.6.92 cm/s±0.24 cm/s,P<0.03),其术后血浆胃动素含量(242.09 pg/ml±17.22 pg/m1)显著高于术前(184.29 pg/ml±9.81 pg ml,P<0.01),且胃电主频、平均幅度和慢波传播速度与胃动素含量呈负相关(P<0.04)。经胃起搏治疗后,模型犬的餐后胃电主频(5.49cpm±0.31 cpm)、平均幅度(3.97mV±0.19mV)和慢波传播速度(5.57 cm/s±0.48 cm/s)均显著高于治疗前(P<0.05),血浆胃动素含量(212.55 pg/ml±11.20 pg/ml)则显著降低(P<0 相似文献
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胃电起搏治疗胃动力障碍疗效观察 总被引:4,自引:2,他引:4
背景:胃电起搏是近年来开展起来的一项治疗胃动力障碍的新方法,其疗效尚不明确。目的:观察胃电起搏治疗对胃动力障碍患者胃肌电活动和症状的影响,以评估其对胃功能紊乱的疗效。方法:对13例胃动力障碍患者行胃电起搏治疗,治疗前后进行胃电图检查和症状评估。结果:胃电起搏治疗后,患者的餐前正常胃电慢波百分比(46.9%±21.6%)与治疗前(41.9%±16.9%)相比无显著差异(P>0.05),餐后正常胃电慢波百分比(78.7%±16.6%)则显著高于治疗前(57.5%±28.6%,P<0.01);治疗后患者的症状亦明显改善。结论:胃电起搏治疗能在短期内改善胃动力障碍患者的胃电节律紊乱和症状。 相似文献
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背景:胃电过速常由胃窦的异位起搏点引起。明确正向低频串脉冲对人工异位起搏点诱发的胃电过速的纠正作用及其相关参数对于胃电起搏的治疗应用具有重要指导意义。目的:测定低频串脉冲正向胃电刺激(FGES)完全控制高频长脉冲逆向胃电刺激(RGES)模拟异位起搏点诱发的胃电过速的最小刺激能量。方法:于比格犬胃大弯浆膜层植入4对电极,从CH4导联输入高频长脉冲RGES诱发胃电过速,刺激参数:0.3mA,300ms,9cpm(次/min)。10min后,在持续给予RGES的同时从CH1导联输入不同振幅的低频串脉冲FGES,以获得完全控制胃慢波的最小刺激能量。记录胃慢波和消化不良症状。结果:低频串脉冲FGES完全控制高频长脉冲RGES诱发的胃电紊乱所需的最小刺激能量为(149.35±50.66)smA2。与基线胃慢波相比,RGES诱发胃电过速显著增多(55.4%±25.1%对2.1%±1.1%,P=0.037),而FGES可纠正RGES诱发的胃电过速,使之恢复至基线水平。胃慢波基线期、RGES期间和FGES RGES期间实验犬消化不良症状无明显差异。结论:正向低频串脉冲能纠正由逆向高频长脉冲模拟异位起搏点诱发的胃窦胃电过速,并改善由此降低的胃动力。 相似文献
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电针四白穴对神经阻断大鼠胃肌电的影响 总被引:1,自引:0,他引:1
目的:探讨电针四白穴,对大鼠胃肌电兴奋途径.方法:大鼠32只,随机分为4组.选用ip抗胆碱能M受体阻断剂阿托品、交感神经节阻断剂六羟季胺和肾上腺素能神经阻断剂利血平,观察电针四白穴对神经阻断大鼠胃肌电的影响.结果:大鼠腹腔注射阿托品、六羟季胺后,慢波高活动相平均振幅、慢波高活动相时程/慢波周期比值以及快波平均峰簇数下降(P<0.01, P<0.05,P<0.01);注射利血平后,以上三种参数分别升高(P<0.01,P>0.05,P<0.01).针刺四白穴能部分取消阿托品、六羟季胺对大鼠胃肌电的抑制效应(P<0.05或P>0.05).结论:电针足阳明经四白穴对胃调控作用的外周通路既有胆碱能神经、交感神经系统的参与,又有肾上腺素能神经系统的参与. 相似文献
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目的探讨正向低频长脉冲胃电刺激对逆向高频长脉冲模拟胃异位起搏点诱发胃电过速的治疗作用。方法7条纯种雌性比格犬,依次沿胃大弯前壁浆膜层植入4对心脏起搏电极。通过距离幽门最近的1对电极输入高频长脉冲电信号诱导内源性胃肌电活动发生胃电过速,刺激参数为0.3mA、300ms、9cpm。刺激10min后,通过距离口端最近的1对电极输入不同振幅的低频长脉冲,直至纠正胃电过速,从而获得正向控制胃电过速的最小能量。观察电刺激前、刺激中和刺激后消化不良症状并进行评分。结果正向低频长脉冲能够完全控制逆向高频长脉冲模拟异位起搏点诱发的胃电过速,最小刺激振幅为(5.0±0.93)mA,最小刺激能量为(1500±277.75)(ms×mA)。获得完全控制的正向低频长脉冲与逆向高频长脉冲相比,正常胃慢波百分率升高(95.61%±3.78% vs42.68%±19.74%,P=0.001),胃电过速百分率降低(3.58%±0.85% vs40.29%±19.68%,P=0.001),主频降低(6.35±0.66 vs5.60±0.85,P=0.031),主功升高(-9.67±5.08 vs-2.26±1.03,P=0.001)。胃慢波基线期、高频长脉冲(RG-ES)期、完全控制的低频长脉冲(FGES+RGES)期的消化不良症状评分均为1分,无明显差异。结论正向低频长脉冲能够完全纠正由高频逆向长脉冲模拟人工 异位起搏点引发的胃电过速,并恢复由此降低的胃动力。 相似文献
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Hui Ouyang 《Scandinavian journal of gastroenterology》2013,48(6):702-707
Objective. To investigate the effects of long pulse gastric electrical stimulation (GES) at a tachygastrial frequency on food intake, gastric tone and gastric myoelectrical activity (GMA). Material and methods. Of twelve dogs implanted with electrodes and a gastric cannula, 6 underwent truncal vagotomy. Stimulus consisted of long pulses with a frequency of 9 cycles/min. Experiment one was performed in all dogs to test for food intake with or without GES. Experiment two on six normal dogs consisted of baseline, GES and recovery periods. Gastric volume and GMA were recorded. Results. 1) GES reduced food intake in both normal (398.5±111.7 g versus 573.0±97.9 g; p<0.02) and vagotomized dogs (170.6±100.4 g versus 401.0±97.3 g; p<0.05). 2) Gastric volume was increased with stimulation from 168.4±17.7 ml to 301.1±34.1 ml (p<0.02 ANOVA) and maintained at 271.8±27.6 ml. 3) The percentages of normal slow waves before, during and after GES were 83.3±4.6%, 38.0±3.5% and 61.0±12.5%, respectively (p=0.02 ANOVA). Conclusion. Long-pulse GES at tachygastrial frequency substantially reduces food intake, and is not mediated by the vagal pathway but attributed to relaxation of the stomach and impairment of intrinsic GMA. 相似文献
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Therapeutic potential of gastric electrical stimulation for obesity and its possible mechanisms: a preliminary canine study 总被引:10,自引:0,他引:10
Our aim was to investigate the effects of gastric electrical stimulation on food intake, weight, gastric myoelectrical, and parasympathetic activity. Dogs were implanted with serosal electrodes and a subcutaneous stimulator. The stimulator was turned on and off alternately every month for 4 months. Food intake, weight, gastric myoelectrical activity, and electrocardiograms were recorded. Daily food intake and weight were significantly decreased during the months with stimulation. Stimulation did not show any acute effect on gastric myoelectrical activity; however, it chronically and significantly impaired gastric myoelectrical activity in the fed state, but not in the fasting state. The parasympathetic activity in the fasting state assessed from the spectral analysis of heart rate variability was markedly decreased with stimulation both acutely and chronically. In conclusion, chronic gastric electrical stimulation results in a reduction in food intake, weight loss, a reduction in parasympathetic activity, and chronic inhibition of gastric myoelectrical activity. These data suggest that gastric electrical stimulation is a potential therapy for the treatment of obesity and its inhibitory effect on food intake and weight may involve both muscles and the vagal afferent pathway. 相似文献
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外源性胃电刺激对犬胃慢波的作用 总被引:1,自引:0,他引:1
目的探讨外源性胃电刺激完全控制胃慢波的最佳刺激方法和最佳刺激参数。方法在8条比格犬的胃大弯浆膜层埋植4对电极,分4组:单导联刺激组、两导联刺激组、三导联刺激组和三导联延迟刺激组。多导联电刺激器与距胃窦上6、10和14cm的浆膜电极相连并输入不同宽度和振幅的脉冲以控制胃慢波。运用多导联胃电记录仪记录胃肌电活动。观察实验中胃慢波、脉冲宽度和振幅。结果长脉冲胃电刺激能控制胃慢波。单导联刺激组所需的最佳刺激能量最小(51.25±12.46,P<0.01)。三导联刺激组较其延迟刺激组所需的最佳刺激能量值低(P<0.01)。刺激前后胃肌电活动的主功和胃慢波的传播速度差异无统计学意义(P>0.05)。结论长脉冲胃电刺激能控制胃慢波,但对胃肌电活动的主功和传播速度无作用。单导联胃电刺激控制胃慢波所需的刺激能量最小。导联之间的延迟时间能增加控制胃慢波所需的最佳刺激能量。 相似文献
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近年来采用胃电刺激治疗胃感觉/运动障碍性疾病的研究取得了令人鼓舞的结果。此文就胃电刺激的方法及其在胃轻瘫和病态肥胖症的临床应用及其作用机制方面的研究结果作一综述。 相似文献
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目的:观察胃电刺激(GES)对大鼠下丘脑腹内侧区(VMH)胃扩张(GD)相关神经元的作用及脑内增食欲素(orexin)表达的影响,初步探讨 GES的中枢作用机制.方法:选用成年Wistar大鼠52只,采用细胞外记录神经元单位放电方法,记录VMH神经元自发放电活动,根据神经元对胃扩张刺激反应的不同,分为胃扩张兴奋性神经元(GD-E) 和胃扩张抑制性神经元(GD-I).观察3组不同参数的胃电刺激(GES1,GES2,GES3)对VMH 内GD-E和GD-I放电频率的影响:GES1(6 mA, 0.3 ms,40 Hz,2 s-on,3 s-off)为标准参数; GES2的串刺激持续时间减少为0.1 s:GES3的串刺激频率减少至20 Hz,其他参数均同GES1.采用免疫荧光组织化学染色方法和放射免疫分析法观测胃电刺激2 h对大鼠下丘脑外侧区 (LHA)增食欲素-A(orexin-A)阳性神经元和不同脑orexin含量表达的影响.结果:VMH记录的96个神经元中有82个神经元(85.41%)对胃扩张刺激(GD,3-5 mL, 10-30 s)有反应,其中31个(37.8%)为胃扩张兴奋性(GD-E)神经元,51个(62.2%)为胃扩张抑制性(GD-I)神经元.GES1,2,3分别兴奋了 55.0%,17.6%,14.3%的GD-E神经元.GES1对 GD-E神经元的作用明显强于GES2和GES3 (P=0.002,P=0.016).63.6%,37.9%和51.9%的GD-I神经元分别被GES1,2,3所兴奋,其中 GES2的兴奋作用较弱(P=0.043).GES1刺激胃窦部2 h,下丘脑LHA orexin-A免疫阳性神经元表达明显减少(6.97±1.51/0.1 mm2 vs 26.62 ±8.30/0.1 mm2,P<0.01):且下丘脑、中脑、延脑和孤束核中orexin免疫反应物(IR)的含量与对照组相比明显减少(112.54±11.58 fmol/ mg vs 185.23±15.22 fmol/mg,P<0.01:71.95 ±8.45 fmol/mg vs 98.48±12.02 fmol/mg. P<0.05;72.36±6.58 fmol/mg vs 101.29± 15.22 fmol/mg.P<0.05;69.12±4.99 fmol/mg vs 89.21±9.23 fmol/mg,P<0.05),但脑桥内 orexin-IR的含量与对照组相比无显著差异.结论:GES可兴奋下丘脑“饱中枢”-VMH内胃扩张反应性神经元,电刺激作用的强弱与 GES刺激的频率和刺激的持续时间有关:脑内 orexin的降低可能也参与了GES的中枢作用机制. 相似文献
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《中华内科杂志》2009,48(11)
目的 研究顺铂(cisplatin,DDP)对胃肌电活动的影响,并探讨胃电刺激(GES)对化疗药物引起的犬呕吐和消化不良症状的治疗效应.方法 7只比格犬的胃浆膜均被植入4对电极,每只犬均先后进行两阶段实验.(1)DDP阶段:给予DDP(1.5 mg/kg),自给药开始持续记录胃电活动及动物症状;(2)GES+DDP阶段:自DDP给药开始,经近端胃体部电极持续给予串脉冲GES,给药剂量、胃电活动及症状记录同DDP阶段.结果 (1)DDP能诱导犬恶心呕吐症状及胃电紊乱:DDP阶段动物均出现频繁呕吐,呕吐次数为(5.5±1.2)次,总症状评分为31.83±2.75.通过胃电记录发现,基线水平时正常胃慢波占(96.50±1.14)%,而呕吐期间正常胃慢波占(69.61±5.81)%(P=0.003),并且胃电过速和胃电过缓发生的百分比均明显高于基线水平(P=0.020和P=0.031).(2)GES能减轻DDP诱导的呕吐和消化不良症状:GES+DDP阶段比格犬的症状评分较DDP阶段明显降低(24.50±1.45比31.83±2.75,P=0.028),并且呕吐次数也明显减少(3.7±0.8比5.5±1.2,P=0.028).但GES对DDP引起的胃电紊乱无明显影响.结论 DDP能诱导犬呕吐和胃电紊乱.串脉冲GES能明显减轻DDP引起的呕吐和消化不良症状,但对胃电紊乱无明显影响. 相似文献
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Bin Yang Xiao-Hua Hou Geng-Qing Song Jin-Song Liu Jiande DZ Chen 《World journal of gastroenterology : WJG》2009,15(19):2406-2411
AIM: To investigate the effect of two-channel gastric electrical stimulation (GES) with trains of pulses on gastric emptying and slow waves.METHODS: Seven dogs implanted with four pairs of electrodes and equipped with a duodenal cannula were involved in this study. Two experiments were performed.The first experiment included a series of sessions in the fasting state with trains of short or long pulses, each lasted 10 min. A 5-min recording without pacing was made between two sessions. The second experiment was performed in three sessions (control, single-channel GES, and two-channel GES). The stimulus was applied via the 1st pair of electrodes for single-channel GES (GES via one pair of electrodes located at 14 cm above the pylorus), and simultaneously via the 1st and 3rd channels for two-channel GES (GES via two pairs of electrodes located at 6 and 14 cm above the pylorus), Gastric liquid emptying was collected every 15 min via the cannula for 90 min.RESULTS: GES with trains of pulses at a pulse width of 4 ms or higher was able to entrain gastric slow waves. Two-channel GES was about 50% more efficient than single-channel GES in entraining gastric slow waves. Two-channel but not single-channel GES with trains of pulses was capable of accelerating gastric emptying in healthy dogs. Compared with the control session, two-channel GES significantly increased gastric emptying of liquids at 15 rain (79.0% ± 6.4% vs 61.3% ± 6.1%, P 〈 0.01), 30 min (83.2% ± 6.3 % vs 68.2% ± 6.9%, P 〈 0.01), 60 min (86.9% ± 5.5 % vs 74.1% ± 5.9%, P 〈 0.01), and 90 rain (91.0% ± 3.4% vs 76.5% ± 5.9%, P 〈 0.01).CONCLUSION: Two-channel GES with trains of pulses accelerates gastric emptying in healthy dogs and may have a therapeutic potential for the treatment of gastric motility disorders. 相似文献