Emptying of the terminal ileum in intact humans. Influence of meal residue and ileal motility.
Emptying of the terminal ileum in intact humans. Influence of meal residue and ileal motility.
复制标题
完整人类的回肠末端排空。
DOI：
10.1016/0016-5085(87)90024-2
复制
发表时间：
1987
期刊：
影响因子：
29.4
通讯作者：
Phillips,SF
中科院分区：
文献类型：
--
作者：
Spiller,RC;Brown,ML;Phillips,SF
通过多腔口结肠管向肠道内注射99M-二乙基三氨基五乙酸，对15名健康人的回肠末端排空进行了评估。随后通过γ-闪烁成像定量同位素在结肠中的到达，并获得结肠充盈曲线。研究是在禁食(n=5)和高残留量(n=5)餐后2.5h内进行的，分别是添加4g瓜尔胶的低残渣餐和高残留餐。两餐后50%的同位素到达结肠的时间(T50)明显加快，高残留组为72±15min，低残留组为62±8min，而禁食组为183±37min(p<；0.01)。虽然添加瓜尔没有显著改变T50，但它确实导致结肠充盈率显著下降，这意味着同位素稀释增加。回结肠交界处的延迟，如结肠充盈曲线中间的平台所示，是不常见的。在10项餐后研究中只有2项和5项禁食研究中有2项存在显著差异。回结肠转移率与回肠平均运动指数或回肠交界处附近特定回肠运动模式的出现无关。空腹回结肠运输具有特征性的不稳定，但与回肠最后60厘米罕见的消化间期移行运动复合体无关。我们的结论是，人类的回结肠运输与回肠内物质积聚的速度有关，在餐后快速(回肠血流高时)，在空腹时缓慢而不稳定。这种方法产生了一致的结果，并可用于确定进一步影响回结肠流入的因素。
Emptying of the terminal ileum was assessed in 15 healthy humans by injecting technetium 99m-diethyltriaminopentaacetic acid into the bowel through a multilumen orocolonic tube. The subsequent arrival of isotope in the colon was quantified by γ-scintigraphy and colonic filling curves were obtained. Studies were performed during fasting (n = 5) cnd 2.5 h after either a low residue meal (n = 5) or a meal made high in residue (n = 5) by adding 4 g of guar. The time for 50% of the isotope to reach the colon (T50) was significantly accelerated after both meals, being 72 ± 15 min for the high residue meal and 62 ± 8 min for the low residue meal, compared with 183 ± 37 min (p < 0.01) in the 5 fasting subjects. Although the addition of guar did not alter T50significantly, it did cause a significant fall in the rate of colonic filling, implying increased isotope dilution. Delay at the ileocolonic junction, as shown by plateaus in the middle of the colonic filling curves, was uncommon. Hold-up was significant in only 2 of 10 postprandial and 2 of 5 fasting studies. Rates of ileocolonic transit could not be related to either a mean ileal motility index or the occurrence of specific ileal motor patterns immediately proximal to the ileocolonic junction. Fasting ileocolonic transit was characteristically erratic but could not be related to interdigestive migrating motor complexes, which were rarely observed in the last 60 cm of ileum. We conclude that ileocolonic transit in humans is related to the rate at which material accumulates in the ileum, being rapid postprandially (when ileal flow is high) and slow and erratic during fasting. This method yields consistent results and could be used to define further factors that influence ileocolonic inflow.