急性颅脑损伤动物的胃肠动力研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:本实验的目的就是研究在急性颅脑损伤初期胃肠动力的改变以及相关影响因素的变化,为临床治疗急性创伤后的胃肠道并发症提供理论和实验室基础。材料和方法:Wistar大鼠50只,分为正常对照组,损伤后6小时组,24小时组,48小时组,72小时组,每组10只。利用Marmarou颅脑打击模型,造成急性颅脑损伤,测定急性期胃肠传输率,门脉血中VIP、胃泌素、胃动素含量,取小肠标本制作病理标本,光镜下观察ICC形态及数量的变化,电镜下观察其结构变化。结果:1.各损伤组与空白对照组相比,胃肠传输率均有显著下降(p<0.001)。胃肠传输率与急性颅脑损伤后神经行为学评分呈显著的中度正相关关系(p<0.05)。2.各损伤组门脉血中VIP含量与对照组相比,均有显著性上升(p<0.05),胃泌素各组含量有上升,24小时组有显著性差异(p<0.05),胃动素含量24小时组有显著性上升(p<0.05),不同实验组中,胃肠传输率与激素,及各种激素之间有不同的相关关系(p<0.05)。3.免疫组化染色及电镜观察到小肠中主要分布着ICC-MY和ICC-DMP两类ICC细胞,半定量统计结果,损伤组与对照组无明显差异。电镜未见结构异常。结论:急性重度颅脑损伤后,6小时起即发生胃肠动力障碍,并且出现胃肠激素的相应变化,直至72小时未完全恢复,ICC细胞72小时内未发生数目、形态、结构等的变化。
Objective:to investigate the change of gastrointestinal motility in the state of acute severe head injury and the change of related factors.
     Methods:50Wistar rats were randomly divided into5groups with10each:Blank group,6hours after trauma group,24hours after trauma group,48hours after trauma group,72hours after trauma group. Make severe head injury model with Marmarou's modeling. Then at the predicted time check the gastrointestinal transmission rate, concentration of VIP,GAS and MTL in the pylic blood, the morphous, number and structure of ICCs distributed in the small intestine muscle layers.
     Results:1.6h-72h after severe head injury, in trauma groups,a function disturbance of gastrointestinal motility could be observed(p<0.001).2. In all trauma groups VIP went up significantly (p<0.05), and GAS went up significantly (p<0.05) in24hour after trauma group, and MTL went up significantly (p<0.05) in the24hour after trauma group. In different groups there were positive or negative correlations significantly between the gastrointestinal transit ratio and hormones, as well as among different hormones.(p<0.05)3. with immunohistochemical method and in TEM ICC-MY和ICC-DMP were both observed, but no obvious differences were observed between blank group and trauma groups.
     Conclusion:6h after severe head injury, a function disturbance of gastrointestinal transit could be observed and wouldn't recover until72h. And gastrointestinal hormones changed significantly. But no obvious differences were observed in ICC among different groups.
引文
1. MannarouA. Pathophysiology of traumatic brain edema:eurrent eoncepts. Aeta Neuroehir SuPPI 2003(86):7-1
    2. EmilieC, Eln们nanuelC, OlivierD, et al.Technical aspects of an impact acceleration traumatic brain injury rat model with potential suitability for both microdialysis and PtiO2 monitoring. J Neurosci Meth2004,140(1-2):23-28
    3. Barzo P, Marmarou A, Fatouros P, et al. Biphasic pathophysiological response of vasogenic and cellular edema in traumatic brain swelling. Acta Neuroehir Suppl (Wien) 1997(70):119-122.
    4. Kimelberg HK. Current concepts of brain edema:review of laboratory investigations. J Neurosurg 1995,83(6):1051-1059.
    5. Pilit sis J G, Rengachary SS. Complications of head injury [J]. J Neurol Res 2001,23 (223):227.
    6. Kirkup AJ, Brunsden AM, Grundy D. Receptors and transmission in the brain-gut axis:potential for novel therapies. I. Receptors on visceral afferent s [J]. Am J Physiol Gastrointest Liver Physiol,2001,280:787.
    7.李国华,侯晓华.胃肠激素与消化道运动[J].胃肠病学,2003,8(3):附3.
    8. Shafik A, Ahmed I. Interstitial cells of Cajal in reflux esophagitis:role in the pathogenesis of the disease[J].Med Sci Monit,2005; 11(12):BR452
    9. Lyford GL, He CL, Soffer E, et al. Pan- colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. [J] Gut,2002;51:496
    10. Langer JC, Berezin I, Daniel EE. Hypertrophic pyloric stenosis:ultrastructural abnormalities of enteric nerves and the interstitial cells of Cajal[J].J Pediatr Surg,1995;30(11):1535
    11. Matejovic,-M; Rokyta,-R Jr; Krouzecky,-A; Gastrointestinal tract dysfunction in critical illness. Novak,-I Cas-Lek-Cesk.2002; 141:46-50
    12. Brathwaite CE, Ross SE, Nagele R, et al. Bacterial translocation occurs in humans after traumatic injury:evidence using immuno-fluorescence [J] J-Trauma,1993.34(4):586-590
    13. Saini,-M-S, Liberati,-D-M. Sequential changes in mucosal immunity after hemorrhagic shock. Diebel,-L-N Am-Surg.2001;67:797-801
    14.刘海鹏,尹志勇,王正国,等.颅脑局部冲击伤——一种新的颅脑损伤模型[J].中华实验外科杂志,1999,16(1):91.
    15. Marmarou A, Foda MA.AE, Brink WVD, et al. A new model of diffuse brain injury in rats. J Neurosurg,1994,80:301-313
    16. Zea Longa E, Weinstein PR, Carison S, et al. Reversible middle Cerebral artery occlusion without craniectomy in rats[J]. Stroke,1989 (20):84-91.
    17. Bederson J B, PittsL H, Tsujim, et al. Rat middle cerebral artery occlusion evaluation of model and development of a neurologic examination[J]. Stroke,1986 (17):472.
    18. C.H.Kao, S.P.ChangLai, P.U.Chieng et al., Gastric emptying in head-injured patients. Am J Gastroenterol 93(1998),pp.1108-1112
    19. M.L.Barclay, R.Fraser, J.-P.Tournadre et al., Small intestinal and gastric motility inpatients in the intensive care unit following elective abdominal aortic aneurysm repair. Gastroenterology 112(1997),p.A694
    20.Bederman SS, Betsy M, Winiarsky R, Seldes RM, Shar-rock NE, Sculco TP.Postoperative ileus in the lower extremity arthroplasty patient.J Arthroplasty 2001;16:1066-70
    21. H.Kehlet, Postoperative ileus.Gut 47 suppl 4(2000),pp.iv85-iv87
    22. H.Kehlet? Acute pain control and accelerated postoperative surgical recovery. Surg Clin North Am 79(1999),pp.431-443
    23. M.Prasad and J.B.Matt, Deflating postoperative ileus[editorial]..Gastroenterology 117(1999),pp.489-492.
    24. Clevers,-G-J;Smout,-A-J The natural course of postoperative ileus following abdominal surgery.Neth-J-Surg.1989 Oct;41(5):97-9.
    25. K.Holte and H.Kehlet, Postoperative ileus:a preventable event.Br J Surg 87(2000),pp.1480-1493
    26.潘国宗,曹世植主编,《现代胃肠病学》1994年,科学出版社
    27.于皆平,沈志祥,罗和生主编,《实在消化病学》1999年,科学出版社
    28.杨敏,房殿春,龙庆林,等.胃起搏前后胃瘫犬胃排空和血浆胃动素的关系[J].重庆医学,2003,32(9):1153.
    29.李亚洁,黄健美,王春慧,等.不同平面脑损伤患者血浆和胃液胃动素含量的动态观察[J].中华内科杂志,2000,39(8):560.
    30.许国铭.胃肠动力研究进展[J].云南医药,1997,18(4):312—315.
    31.秦新,雷勇.胃肠肤激素与胃肠动力[J].中国实有外科杂志,2001,21(6):229—331.
    32.陈天娥,王秀琴.大鼠脾气虚胃溃疡证病结合模型胃肠粘膜局部免疫神经内分泌网络的变化[J].解剖学报,2003,34(4):441-444.
    33.李国华,侯晓华.胃肠激素与消化道运动[J].胃肠病学,2003,8(3):附3.
    34. Smout AJPM, Akkemans LMA. Action of smooth muscle cells. In:Smout AJPM, Akkermans LMA eds. Normal and disturbed motility of the gastrointestinal tract. Peterefied,Nampshire,UK,Wrightson biomedical publishing Ltd.1992,42-6.
    35. Sanders KM. A case for interstitial cells of Cajal as Pace makers and mediators of neurotransmission in the gastrointestinal treat. Gastroenterology,1996.111:92-515.
    36. Horowitz, Ward, Sanders.Cellular and molecular basis for electrieai rhythmicity ingastrointestinal muscles. Annu-Rev-Physiol.1999;61:19-43.
    37. Ward SM, Burns AJ, Torihashi S, et al. Impaired development of interstitial cells and intestinal electrical rhythmicity in steel mutants. Am J Physiol,1995,269:C1577-C1585.
    38. Mikkelsen HB, Malysz J, Huizinga JD, et al. Action potential generation, Kit receptor immunohistochemistrty and morphology of steel-Dickie(Sl/Sld)mutant mouse small intestine. Neurogastroenterol Motil,1998,10:11-26.
    39. Shafik A, Ahmed I. Interstitial cells of Cajal in reflux esophagitis:role in the pathogenesis of the disease[J]. MedSci Monit,2005; 11(12):BR452
    40. Lyford GL, He CL, Soffer E, et al, Pan- colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. [J] Gut,2002;51:496
    41.Langer JC, Berezin I, Daniel EE. Hypertrophic pyloric stenosis; ultrastructural abnormalities of enteric nerves and the interstitial cells of Cajal[J].J Pediatr Surg,1995;30(11):1535
    42. Concepcion Junquera, Carmen Martinez-Ciriano, Tomas Castiella et al, Immunohistochemical and ultrastructural characteristics of interstitial cells of Cajal in the rabbit duodenum. J. Cell. Mol. Med. Vol 11, No 4,2007 pp.776-787
    43.刘婧,李兆申,许国铭.创伤急性期血浆内CCK28,VIP,SS,GAS含量变化[J]上海医学,2000,23(5):293.
    44.蒋红梅,朱京慈.重型颅脑损伤后大鼠胃肠动力障碍与血浆MTL.VIP变化的实验研究.重庆医学,2007,36(11):1048
    45. Clevers,-G-J;Smout,-A-J.The natural course of postoperative ileus following abdominal surgery.Neth-J-Surg.1989 Oct;41(5):97-9
    1.潘国宗,曹世植主编,《现代胃肠病学》1994年,科学出版社
    2.于皆平,沈志祥,罗和生主编,《实在消化病学》1999年,科学出版社
    3. Szurszwesi JH。A migrating electric complex of the canine small intestine Am J Physiol 1969;21:1757
    4. Vantrappen G, Janssens J, Hellemans J, et al. The interdigestive motor complex of normal subjects and patients with baeterial overgrowth of the small intestine. J Clinlnvest 1977;59:1158
    5. Code CF, et al The interdigestive myoelectric complex of the stomach and small bowel of dogs. J Physiol 1975;246:289
    6. Wingate DL Backwards and forwards with the migrating complex. Dig Dis Sei 1981;26:641
    7. Lang IM, Sarna S, Condon RE Generation of Phase Ⅰ and PhaseⅡ of migrating myoelectric complex in the dog. Am J Physiol 1986;251:G201
    8. Carlson GM, et al. Mechanism of Propagation of interdigestive myoelectric complex. Am J Physiol 1972;222:1027
    9. Surprenant A. Control of the gastrointestinal tract by enteric neurons. Annu Rev physiol 1994;56:117
    10. Bornstein JC, Furness BJ, Kunze WAA Electrophysiological characterization of Myenteric neurons:how to classification schemes relate? J Autonom Neyv Sys1994;48:1
    11. Wood JD. Enteric nervous system. Motility 1995:5:4
    12.周吕肠神经系统脑肠肽,中华消化杂志,1996:16:287
    13. De Vault K, Rattan S. Physiological role of neuropeptides in the gastrointestinal Smooth muscles phincters:neuropeptides and VIP-nitric oxide interactions. In walsh Jh, Dockray GJ(eds).Gut PePtides. Raven Press, New York,1995:715
    14. Ward SM, Sanders KM. Physiology and pathophysiology of the interstitial cell of Cajal:from bench to bedside. I. Functional development and plasticity of interstitial cells of Cajal networks [J]. Am J Physiol Gastrointest Liver Physiol,2001,281(3): G602-G611.
    15. Torihashi S, Fujimoto T, Trost C, et al. Calcium oscillation linked to pacemaking of interstitial cells of Cajal [J].J Biol Chem,2002,277(21):19191-19197.
    16. Sanchez MJ, Bockamp EO, Miller J, et al.Selective rescue of early haematopoietic progenitors in Scl-/-mice by expressing Sclunder the control of a stem cell enhancer[J].Development,2001,128:4815-4827.
    17. Sanders KM. A case for interstitial cells of Cajal as Pacemakers and mediators of neurotransmission in the gastrointestinal tract. Gastroenterology 1996;111:492
    18.RumessenJJ, Thuneberg L. Pacemaker cells in the gastrointestinal tract:Interstitial cells of Cajal. Scan J gastroenterol 1996;31:82
    19.张经济,连至诚,许冠荪,等.消化道生理及病理生理学[M].广州:广东科技出版社,1997:60-73.
    20.秦新裕,雷勇.胃肠肽激素与胃肠动力[J]中国实用外科杂志,2001,21(6):229-331.
    21. Chey WY. Hormonal control of gastrointestinal motility, Chin Natl J New Gastroenterol 1996.2(suppll):22
    22. MinekoF, Akiol. Peptidergic regulation of gastrointestinal motility in rodents. Peptides21(2000):1565-1582.
    23. Zenikman ME, Paroi JE, Becker JM Preservation and Propagation of cyclic myoeleetric activity after feeding in rat small intestine.AmJPhysiol1992;263:G248
    24. Sarna SK. Cyclic motor activity, migrating motor complex. Gastroenterolgy 1985;89:894
    25. Itoh Z, Honda R, Ajzawa I, et al Interdigestive motor activity of the lower esophageal sphineter in the conscious dog. Am J Dig Dis1979;23:239
    26.Marik F, Code CF. Control of the interdigestive myoelectric aetivity in dogs by the vagus nerves and pentagastrin.Gastroenterolgy1975;69:387
    27.Sarna S, Condon RE, Cowles V. Enteric mechanisms of initiation of migrating myoelectric complexes in dogs.Gastroenterology1983;84:814
    28. Kellow K, Borody TJ, Phillips FT, et al. Human interdigestive motility:variations in pattern from esophagus to colon. Gastroenterologyl986;91:386
    29.Krgalund K, Hjermind J, Jensen FT, et al. Gall-bladder empyting and gastrointestinal cyclic motor activity in humans. Seand J Gastroenterol 1984; 19:990
    30. Matsumoto T, Sarna SK, Condon R, et al. Diffrential sensitivities of morphine and motilin to initiate migrating motor complex in isolated intestinal segments Gastroenterology 1986;90:61
    31. Lang IM, Sarna S, Condon RE.Generation of phase Ⅰ and Phase Ⅱ of migrating myoelectric complex in the dog. Am J Physiol 1986;251:G201
    32. Koh SD, Sanders KM, Ward SM, et al. Spontaneous electrical rhythmicity in cultured interstitial cells of Cajal from the murine small intestine[J].J Physiol,1998;513(1):203
    33. Spencer NJ, Sanders KM, Smith TK,et al. Migrating motor complexes do not require electrical slow waves in the mouse small intestine[J]. J Physiol,2003;553(3):881
    34. Langton P, Ward SM, Sanders KM, et al. Spontaneous electrical activity of interstitial cells of Cajal isolated from canine proximal colon[J].Proc Natl Acad Sci USA,1989; 86(18):7280
    35. Ward SM, Dixon RE, Sanders KM, et al. Voltage-dependent calcium entry underlies propagation of slow waves in canine gastric atrium[J]. J Physiol,2004; 561(3):793
    36. lino S, Ward SM, Sanders KM, et al. Interstitial cells of Cajal are functionally innervated by excitatory motor neurons in the murine intestine[J].J Physiol,2004; 556(2): 521
    37. Ward SM, Elizabeth A, Sanders KM, et al. Interstitial cells of Cajal mediate cholinergic neurotransmission from enteric motor neurons[J].J neurosci,2000; 20(4):1393
    38. Takeuchi T, Fujinami K, Fujita A, et al. Essential role of the interstitial cells of Cajal in nitric oxide-mediated relaxation of longitudinal muscle of the mouse ileum[J].J Pharmacol Sci,2004,95:71
    39.周吕,王玲.促胰液素通过大鼠Cajal间质细胞促进胃平滑肌舒张[J].基础医学与临床,2003;23(6):612
    40. Rolle U, Piotrowska AP, Nemeth L, et al. Altered distribution of interstitial cells of Cajal in Hirschsprung disease. Arch Pathol Lab Med,2002,126(8):928-933.
    41. Suzuki T, Won KJ, Ward SM, et al. Muscularis inflammation and the loss of interstitial cells of Cajal in the endothelin ETB receptor null rat[J].Am J Physiol Gastrointest Liver Physiol,2004;287:G638
    42. He CL,Burgart L,Wang L,et al.Decreased interstitial cell of Cajal volume in patients with slow-transit constipation.Gastroenterology,2000,118:14-21.
    43. Lyford GL,He CL,Soffer E,et al.Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation.Gut,2002,51:496-501.
    44. Shafik A, Ahmed Ⅰ. Interstitial cells of Cajal in reflux esophagitis:role in the pathogenesis of the disease[J].Med Sci Monit,2005; 11(12):BR452
    45.童卫东,蔡文琴.长期应用大黄对大鼠结肠肌电及Cajal间质细胞的影响[J].第三军医大学学报,2000;22(4):351
    46. Langer JC, Berezin Ⅰ, Daniel EE. Hypertrophic pyloric stenosis:ultrastructural abnormalities of enteric nerves and the interstitial cells of Cajal[J].J Pediatr Surg,1995; 30(11):1535
    47. Horvath VJ, Vittal H, Ordog T, et al. Reduced insulin and IGF-Ⅰ signaling, not hyperglycemia, underlies the diabetes-associated depletion of interstitial cells of Cajal in the murine stomach[J].Diabetes,2005; 54:1528
    48. Nakayama S, Ohya S, Liu HN, et al. Sulphonylurea receptors differently modulate ICC pacemaker Ca2+activity and smooth muscle contractility[J].J Cell Sci,2005; 118: 4163
    49. Kothari MS, Kosmoliaptsis V, Thomas JM. Small bowel Gastrointestinal Stromal Tumors can physiologically alter gut motility before causing mechanical obstruction[J].International Seminars in Surgical Oncology,2005; 2:24
    50. Wang XY, Berezin I, Huizinga JD, et al. Pathology of interstitial Cells of cajal in relation to inflammation revealed by ultrastructure but not immunohistochemistry[J].Am J Pathol,2002; 160(4):1529
    51. Di Nardo G, Stanghellini V,Cucchiara S, et al. Enteric neuropathology of congenital intestinal obstruction:A case report[J].World J Gastroenterol,2006; 12(32):5229
    52.梅峰,于彬,周德山,等.豚鼠空肠吻合术后ICCs的再生及细胞网络再形成研究[J].第三军医大学学报,2005;27(5):376
    52.朱金照,许其增,刘庆宏,等.肝硬化大鼠胃窦Cajal间质细胞的变化[J].胃肠病学和肝病学杂志,2005;14(6):618
    53.蔡文琴.胃肠道的神经支配.组织胚胎学研究进展(何泽涌主编),北京,人民出版社.1987.
    54. Wood.JD.Enteric nervous system in pathogensis of gastrointestinal motility disorders. Chin Natl J New Gastroenterol,1996,2(suppll):26-31.
    55. Russo A, Fraser R, Adaehi K, et al. Evidence that nitric oxide mechanisms regulate small intestinal motility in humans. Gut,1999,44(1):72.
    56.余保平,王伟岸.消化系统疾病免疫学[M].北京:科学出版社,2000:49-53.
    57.李艳梅,黄裕新.脑肠肽及细胞因子在针刺调控胃肠免疫机制中的作用[J].世界华人消化杂志,2001,9(3):329-332.
    58.何美容,宋于刚,智发朝,等.功能性消化不良患者胃动力障碍与胃肠激素及G、D细胞的关系[J].中华消化杂志,2004,24(1):56-57.
    59. Kunt T, Forst T, Schmidt S, et al. Serum levels of substance P are decreased in patients with typel diabetes [J]. Exp Clin Endocrinol Diabetes,2000,108(3):164-167.
    60. Rushakoff RA, Goldfine ID, Beccaria LJ, et al. Reduced postprandial cholecystokinin (CCK) secretion in patients with noninsulin2dependent diabetes mellitus:evidence for a role for CCKin regulating postprandial hyperglycaemia[J]. J Clin Endocrinol Metab 1993,76 (2):489-493.
    61.林琳,计敏,赵志泉,等.糖尿病结肠动力障碍与几种胃肠激素变化的意义[J].江苏医药杂志,2003(8):15-19.
    62.杜立峰,展淑琴,郭新奎.P物质、血管活性肠肽与异常胃肠通过的关系[J].西安交通大学学报(医学版),2003,24(4):363-367.
    63.张茹.胃肠激素与肠易激综合征[J].标记免疫分析与临床,2004,11(1):44-46.
    64.刘丽宏,梅其炳,陈蕾,等.5-羟色胺对培养胃底平滑肌细胞内游离钙动员的影响[J].第四军医大学学报,2001,22(10):891.
    65.李兆申,董文珠,邹多武,等.肠易激综合征黏膜肥大细胞的实验研究[J].解放军医学杂志,2002,27(7):628-630.
    66. Spiller RC, Jenkins D, Thornley JP, et al. Increased reactal mucosal enteroendocrine cells, T lymphocytes and increased gut permeability following acute campy lobacter enteritis and in post dysenteric irritable bowel syndrome Gut [J] 2000,47(6):804-811.
    67.周吕,胃肠动力与相关受体,基础医学与临床。2001.21:13-15
    68. Kalff JC, Carlos TM, Schraut WH, et al.Surgically induced leukocytic infiltrate within the rat intestinal museularis mediate post operative ileus [J].Gastroenterology, 1999,117:378-387.
    69. Kalff JC, Sehraut WH, Billiar TR, et al. Role of inducible nitric oxide synthase in post operative intestinal smooth musele dysfunction in rodents[J].Gastroenterology, 2000,118:316-327.
    70. Sehwartz NT, Beer-Stolz D, Simmons RL, et al. Pathogenesis of Paralytic ileus:intestinal manipulation opens a transient pathway between the intestinal lumen and the leukocytic infiltrate of the jejunal museularis. Ann surg,2002,235:31-40.
    71. De Winter By, Robberecht P, Boeekxstaens GE, et al. Role of VIP/PACAP receptors in post operative ileus in rats (J].Br J Pharmocol,1998,124:1181-1186.
    72. Nakae Y, Kagaya M, Takasi R. Matsutam Y, Horibo H, Kondo T. Cold pain prolongs gastric empting of liquid but not solid meal:an electrical impedance tomography(EIT) study. J Gastroentrol,2000,35(8):593-597
    73. Camilleri M et al. Influence of somatovisceral reflexs and selective dermatonal stimulation posticbal antral pressure activity in man. Am J Physiol,1984;247:G703
    74. Vallori RM et al. Effects of the fasting motor complex jn humans. Gastroenterologyl, 1986;90:1890
    75. Welgan P et al. Effect of anger on colon motor and myoelectric activity in irritable bowel syndrome. Gastroenterologyl,1988;94:1150
    76. Almy TP.Expenmental studies on the irritable colon. Am. J Med,1951;9:60
    77. Tache-Y; Martinez-V; Million-M; Rivier-J. Corticotropin-releasing factor and the brain-gut motor response to stress. Can-J-Gaslroenterol,1999; 13 SuppIA:18A-25 A
    78. Monnikes-H; Sehmidt-BG; Tache-Y Psychological stress-induced accelerated colonic transit in rats involves hypothalamic corticotropin-releasing factor Gastroenterology.1993:104 (3):716-23
    79. Lee C, Sarna SK. Central regulation of gastric empting of solid nutrient meals by corticotrophin releasing factor. Neurogastroenterol Motil,1997:9(4):221-229
    80. Tache Y, Martinez V, Million M, Wang L. Stress and the gastrointestinal tract Ⅲ. Stress-related alterations of gut motor function:role of brain corticotropin·releasing factor receptor. Am J Physiol Gastrointest Liver Physiol,2001;280(2):G173-177
    81. Maillot C,Million M, Wei JY, Gauthier A,Tache Y Peripheral corticotropin·releasing factor and stress-stimulated colonic motor aetivity involve type 1 receptor in rats.Gastroenrology2000; 119(6):1569-1579
    82. Smadja C, Maldonado R. Tureaud S, Fournie-Zaluski MC, Roques BP. Opposite role of CCKA and CCKB receptors in the modulation of endogenous enkephalin antidepressant-like effects. Psychopharmacology,1995,120(4);400-408
    83. Gue M, Tekam PA, Tabis N, Jumen JL, Bueno L. Cholecysto kinin blockade of emotional stress-and CRF-induced colonic motor alterations in rats:role of the amygdala.Brain Res,1994;658(1-2):232-238
    84. Bueno L. Involvement of brain CCK in the adaptation of gut motility to digestive status and stress. J Physiol Paris,1993;87(5):301-306
    85. Rekik M, Delvaux M, Frexjnos J, Bueno L. Role of vasoactive intestinal polypeptide in the adaptation of intestinal smooth muscle cells to mechanical distension. J Pharmacol. Exp Ther,1998;287(3):832-838
    86. Smith A, Barelay C, Quaba A, et al. The bigger the burn, the geater the stress. Burns, 1997;23(4):291-294
    87.郝悦,黄裕新,王景杰.心理性应激对大鼠胃排空的影响及胃粘膜的损伤[J].第四军医大学学报,2002,23(7):603-605.
    88. Tsukada F, Sawamura K, Kohnol Mechanism of inhibition of small intestinal motility by restraint stress differs from that with morepinephrine treatment in rats [J] Bio 1 Pharm bull,2002,25(1):122-126.
    89. Muelas M S, Ramirez P, Vagal system involvement in changes in small bowel motility during restraint stress:an experimental study in the dog[J]lBr J Surg,1993,80 (4):479-483.
    90. Rao SS, Hatfield RA, Suls JM 1 P sycho logical and physical stress induce differential effects on human colonic motility [J].Am J Gastroenter,1998,93(6) 985-990.
    91. Lin ZY, McCallum RW, Schirmer BD,et al. Effects of pacing parameters on entrainment of gastric slow waves in patients with gastroparesis. Am J Phys,1998,274 (1):186
    92. Tack J,Coulie B, van Cutsem E,et al. Effects of high frequency gastric stimulation on gastric slow waves, gastric emptying and symptoms in patients with gastroparesis. Gastroenterology,2000,118(2):393
    93.周吕,柯美云.神经胃肠病学与动力基础与临床.北京:科学出版社,2005:501-509.
    94.柯美云,胃肠功能和动力障碍研究进展,现代消化及介入诊疗2004,1(9):1-4

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700