功能性消化不良患者胃排空障碍与血浆胃动素和生长抑素的关系

<正>研究表明功能性消化不良(FD)发生与胃肠动力障碍密切相关,胃肠激素是影响胃肠动力的重要因素,其含量改变必然引起FD患者的胃肠动力改变,临床主要表现为胃排空     

功能性消化不良患者的胃动素和生长抑素与胃排空的相关性研究

目的 探讨功能性消化不良(FD)患者体内血浆胃动素和生长抑素与胃排空的关系。方法 分析检测了35例FD患者和26例正常健康人的胃动素和生长抑素,同时检测胃排空情况。结果 胃动素和生长抑素分别较正常对照组具有显著性差异(P<0.01)。结论 胃动素和生长抑素可能是FD的重要原因。     

功能性消化不良患者血浆胃动素生长抑素与胃排空的关系

目的：探讨功能性消化不良（FD）患者空腹血浆胃动素和生长抑素与胃排空的关系。阐明其发病机理。方法：检测了35例FD患者的空腹血浆胃动素和生长抑素，同时进行了胃液体排空超声检测。其中8例进行了标准试餐加服固体钡条的放射线胃排空试验。结果：胃肠激素检测：胃动素测定，FD组为287．3&#177;53．8Pg／ml，对照组为366．4&#177;57．6pg／ml（p〈0．01）；生长抑素测定：FD组19．19&#177;5．82pg／ml，对照组为：8．85&#177;3．65pg／ml（p〈0．01）；胃排空测定：胃液体排空t1／2；FD组48．43&#177;9．32分，对照组t1／2为：26．78&#177;3．24分。胃固体排空：6小时查FD组3例，对照组1例仍有1条以上钡条潴留胃内。7小时查FD组，部分病例仍有钡条潴留胃内，对照组全排空。结论：结果提示：促进与抑制胃运动的两类激素分泌失调可能是FD的重要原因     

功能性消化不良患者胃排空时间和血浆胃动素的相关性与临床研究

目的研究分析功能性消化不良患者胃排空时间和血浆胃动素的相关性与临床意义。方法对40名健康者和80例FD患者应用实时超声显像法进行胃排空时间测定。受试者空腹饮水后0、10、20、30、40、50 min测定胃窦面积和胃体-底交界区前后壁切面内径,测定胃起始收缩时间和2 min收缩次数;并空腹测其血浆胃动素水平。结果 80例FD中有70%存在胃液体排空延迟,且与胃起始收缩时间和2 min收缩次数相关。FD患者血浆胃动素水平明显低于正常组。结论 FD发病确与胃动力障碍有关,胃肠激素中胃动素在FD发病中也起一定作用。     

胃动素与功能性消化不良研究进展

胃动素作为一种新的胃肠激素在多种消化不良疾病中起着不同的作用,但对其作用机制说法不一。针对这一问题,本文对胃动素与功能性消化不良关系的最新研究进展作一综述。     

功能性消化不良患者胃动素及降钙素基因相关肽表达水平的变化

目的 探讨功能性消化不良(functional dyspepsia,FD)患者血浆及胃黏膜中的胃动素(motilin,MTL)及降钙素基因相关肽(calcitonin gene related peptide,CGRP)的表达水平的变化.方法 选取就诊于本院的77例FD患者纳入FD组,并选取同期本院体检的健康者77例纳入对照组,采用ELISA分析法检测所有研究对象血浆及胃黏膜中的MTL和CGRP的表达水平,进行统计学分析.结果 FD组中空腹血浆及胃黏膜中的MTL含量均较对照组明显降低(分别是P=0.001,P＜0.001),而空腹血浆及胃黏膜中的CGRP含量差异无统计学意义.结论 MTL在血浆及胃黏膜中的下降可能为FD的发病机制之一.     

术连饮治疗功能性消化不良的实验研究

目的探讨术连饮对功能性消化不良大鼠肠动力的影响及其可能的作用机制。方法将SD大鼠随机分组,每组10只,分别为正常组、模型组、术连饮组和西沙比利组。制作功能性消化不良大鼠动物模型,以葡聚糖蓝-2000为胃肠内标记物,观察大鼠肠道传输速率的变化。测定大鼠血浆及十二指肠组织胃动素、生长抑素的水平。结果模型组大鼠肠道传输速率明显降低(P0.05),血浆及十二指肠组织MOT含量明显降低(P0.01)、SST含量明显升高(P0.01)。术连饮能够显著促进模型大鼠肠道传输速率(P0.05),显著增加血浆及十二指肠组织MOT含量(P0.05),降低SST水平(P0.05)。结论术连饮能够改善FD大鼠肠运动障碍,其作用机制可能通过提高血浆及十二指肠组织MOT,降低SST,以促进肠动力。     

健运复元汤治疗功能性消化不良76例

目的观察健运复元汤治疗功能性消化不良的临床疗效。方法将符合功能性消化不良诊断标准的患者用健运复元汤加减治疗,并对治疗结果进行评价。结果治疗2个疗程后,患者总有效率达89.47%。结论健运复元汤治疗功能性消化不良疗效确切,值得推广。     

Omeprazole raises somatostatin and motilin in human plasma

Omeprazole, a proton pump inhibitor (PPI), is widely used in treatment of peptic ulcer, gastro esophageal reflux disease and eradication of Helicobacter pylori. PPIs inhibit final gastric acid secretion stage by blocking H+/K+-ATPase. But the mechanism except for gastric antisecretory effect has not understood clearly. So, we examined the effects of omeprazole on the levels of gastrointestinal peptides (somatostatin, motilin, gastrin, vasoactive intestinal peptide (VIP), substance P (SP) and calcitonin gene-related peptide (CGRP)) in plasma from healthy subjects. After a single oral administration of omeprazole, the plasma omeprazole concentration was highest at 120 min. Omeprazole caused a significant increase of plasma somatostatin-immunoreactive substance (IS) levels at 60-240 min and plasma motilin-IS levels at 120-180 min, compared with a placebo group, respectively. The physiological release of plasma gastrin-IS was reduced by the administration of omeprazole at 60 min, but the medicine did not alter the levels of VIP-, CGRP- and SP-IS. These results suggested that the pharmacological effects of omeprazole on regulation of gastrointestinal function are closely related to changes of somatostatin-, motilin- and gastrin-IS levels in human plasma.     

Effects of erythromycin on plasma gastrin, somatostatin, and motilin levels in healthy volunteers and postoperative cancer patients

Erythromycin, an antibiotic agent, is known to be a motilin receptor agonist. Motilin is a peptide hormone that regulates gastric motility. One of the gastrointestinal motility regulatory factors has been assumed to be the induction of changes in the levels of peptides (gastrin, somatostatin and motilin) in plasma. We have elucidated the effects of erythromycin by examining changes in the plasma levels of gastroinitestinal peptides. In this study, we investigated the effects of erythromycin on the plasma levels of gastrointestinal peptides (somatostatin, motilin, and gastrin) in healthy volunteers and patients with delayed gastric emptying (DGE). After a single oral administration, erythromycin caused a significant increase in plasma gastrin-like immunoreactive substance (IS) levels at 60 min. But the agent did not alter the levels of somatostatin- and motilin-IS. DGE is the most frequent postoperative complication after pylorus-preserving pancreatoduodenectomy. Molitin is assumed to be one important factor that influences DGE. We also examined the effects of erythromycin on the plasma motilin-IS levels of postoperative patients. The plasma motilin-IS levels were increased after 1 week of oral administration of erythromycin compared with preadministration. These results suggest that the pharmacologic effects of erythromycin in promoting gastric emptying are closely related to changes in plasma motilin-IS levels.     

Gallbladder volume as a biomarker for the motilin effect in healthy volunteers and patients with functional dyspepsia

AIM: To investigate a motilin effect on gallbladder volume in healthy volunteers and patients with functional dyspepsia. METHODS: Forty-three healthy volunteers and 10 patients with functional dyspepsia received motilin (4 pmol.min/kg) or placebo in four separate double-blind, randomized, placebo-controlled, cross-over studies. The gallbladder volume was measured by ultrasonography. Analysis of variance of the combined data of these studies was performed to investigate a motilin effect on gallbladder volume and potential differences between patients and healthy volunteers. RESULTS: The baseline gallbladder volume was similar for placebo and motilin treatment, as well as for patients and healthy volunteers. Motilin, compared with placebo, significantly decreased the gallbladder volume in healthy volunteers (P = 0.003) and patients (P < 0.0001). A linear concentration-response relationship was observed. The decrease in gallbladder volume by motilin was greater in patients (P = 0.03). The motilin effect was consistent between studies. CONCLUSION: The interdigestive gallbladder volume is a non-invasive end-point for motilin activity, displaying a consistent response across studies, a clear response to motilin and a clear concentration-response relationship. However, it is less suitable as a biomarker for future pharmacological studies on motilin agonists or antagonists as the effect is probably indirect, and a relatively large study population of 27 subjects is required to demonstrate a 15% decrease in gallbladder volume. Further investigation is required to confirm altered gallbladder motility as a feature of functional dyspepsia.     

天麻素治疗伴焦虑抑郁症状功能性消化不良的疗效观察

目的：观察天麻素治疗伴焦虑抑郁症状功能性消化不良的疗效。方法：选择110例伴焦虑抑郁症状的功能性消化不良确诊病例,随机分为治疗组和对照组,所有入选病例均给予奥美拉唑胶囊20mg,1次/d;多潘立酮片10mg,3次/d。治疗组同时服用天麻素胶囊100mg,3次/d。疗程4周。结果：治疗2、4周后,对照组总有效率分别为46.3%和61.1%;治疗组总有效率分别为66.1%和91.9%。组间比较,总有效率差异有统计学意义（P〈0.05,P〈0.01）。结论：天麻素对伴焦虑抑郁症状的功能性消化不良患者具有较好治疗效果。     

胃痛消痞方对肝郁脾虚型FD大鼠胃泌素和生长抑素的影响

目的探讨胃痛消痞方对功能性消化不良(Functional dyspepsia,FD)大鼠血清及胃窦、十二指肠组织中胃泌素(GAS)和生长抑素(SS)的影响。方法 40只Wistar大鼠随机分为正常对照组、模型组、胃痛消痞方组、西沙必利组。除正常对照组大鼠外,通过改良夹尾刺激法建立FD大鼠模型,胃痛消痞方(中药)组与西沙必利(西药)组灌服相应药物3周,模型组与对照组进行对照观察。ELISA、免疫组化测定大鼠血清与胃窦、十二指肠组织中GAS、SS含量。结果与对照组相比,模型组大鼠GAS血清含量及胃肠组织表达减低;经中西药干预治疗后,与模型组相比,GAS含量均明显增高。中药组GAS含量显著高于西药组,差异有统计学意义(P<0.05);各治疗组GAS均低于正常对照组(P<0.05)。与对照组比较,模型组大鼠SS血清含量及胃肠组织表达显著增高;经中西药干预后,与模型组相比,SS明显下降,中药组SS含量显著低于西药组,差异有统计学意义(P<0.05);各治疗组SS含量均高于正常对照组(P<0.05)。结论功能性消化不良可以引起大鼠GAS、SS水平改变,胃痛消痞方可以提高FD大鼠血清及胃窦、十二指肠组织中GAS含量,降低SS含量。     

Effects of mosapride citrate on human plasma levels of motilin, gastrin, somatostatin, and secretin

The effect of mosapride citrate (mosapride) on plasma levels of gastrointestinal peptides (motilin, gastrin, somatostatin, and secretin) was studied in five healthy volunteers. After a single oral administration of mosapride (15 mg), the plasma mosapride level (85.0+/-13.7 ng/ml) was highest in the 60-min sample after the administration and then the plasma level fell. Peak plasma motilin levels (18.6+/-1.7 pg/ml) were achieved 60 min after administration of mosapride (p<0.01 vs. placebo), and returned to baseline levels within a further 120 min. Plasma gastrin levels (42.4+/-3.6 pg/ml) increased 60 min after administration of mosapride (p<0.01 vs. placebo). Plasma somatostatin and secretin levels did not change significantly. These results suggest that the pharmacological effects of mosapride on gastrointestinal functions are closely related to changes in motilin-immunoreactive substance levels in human plasma.     

双歧杆菌四联活菌片联合多潘立酮对小儿功能性消化不良的临床疗效及其对血浆P物质和胃动素水平的影响

目的 探讨双歧杆菌四联活菌片联合多潘立酮对小儿功能性消化不良胃电节律、血浆P物质及胃动素水平的影响。方法 选取2016年3月—2019年3月徐州市第一人民医院108例功能性消化不良患儿作为研究对象,根据随机数字表法将患者分为对照组和观察组,每组各54例。对照组患儿餐前30 min口服多潘立酮混悬液,3岁以内3~4 mL/次,3次/d;4~6岁患儿5~6 mL/次,3次/d;7岁以上患儿7~10 mL/次,3次/d。观察组患儿在对照组的基础上口服双歧杆菌四联活菌片,1~6岁患儿1.0 g/次,2~3次/d;6岁以上患儿1.0~1.5 g/次,3次/d。两组均连续治疗14 d。观察两组患儿的临床疗效,同时比较两组治疗前后的症状评分、胃电节律异常发生率、血浆P物质和胃动素水平。结果 治疗后,观察组患儿治疗总有效率为94.44%,显著高于对照组的79.63%,两组比较差异具有统计学意义（P<0.05）。治疗后,两组患者各症状评分均明显降低（P<0.05）,且观察组症状评分显著低于对照组（P<0.05）。治疗后,两组患儿餐前及餐后胃电节律异常发生率均明显降低（P<0.05）,且观察组胃电节律异常发生率显著低于对照组（P<0.05）。治疗后,两组患儿血浆P物质及胃动素水平均明显升高（P<0.05）,且观察组P物质及胃动素水平显著高于对照组（P<0.05）。结论 双歧杆菌四联活菌片联合多潘立酮可通过改善胃电节律、提高血浆P物质及胃动素水平的影响来改善患儿临床症状,疗效确切,值得在小儿功能性消化不良治疗中应用推广。     

Effects of domperidone on human plasma levels of motilin, somatostatin, gastrin, adrenocorticotropic hormone and cortisol

Domperidone, an upper gastrointestinal function regulatory medicine, has recently been evaluated for its clinical usefulness in the treatment of stress and depression. We examined the effects of domperidone on the plasma levels of motilin-immunoreactive substance (IS), somatostatin-IS, gastrin-IS, adrenocorticotropic hormone (ACTH)-IS, and cortisol under stress conditions by repetitive blood sampling. After a single oral administration of domperidone (30 mg), the plasma domperidone level was highest (58.6+/-6.4 ng/ml) in the sample taken 40 min after administration, after which the plasma level fell. Peak plasma motilin-IS levels (23.1+/-1.4 pg/ml) were achieved 40 min after administration of domperidone (p < 0.01 vs. placebo), and returned to baseline levels within a further 40 min. Plasma somatostatin-IS levels (13.0+/-1.2 pg/ml) increased 60 min after administration of domperidone (p < 0.01 vs. placebo). Plasma gastrin-IS levels did not change significantly. These results suggest that the pharmacological effects of domperidone on gastrointestinal functions are closely related to changes in motilin-IS and somatostatin-IS levels. Domperidone significantly suppressed increases in plasma ACTH-IS and cortisol levels compared with the response to a placebo. These modulatory effects might be beneficial in stress-related diseases and suggest that this medicine has clinical pharmacological activity.