Directed endoscopic mucosal mapping of normal and dysrhythmic gastric slow waves in healthy humans
Directed endoscopic mucosal mapping of normal and dysrhythmic gastric slow waves in healthy humans
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DOI：
10.1111/j.1365-2982.2004.00542.x
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发表时间：
2004-10-01
影响因子：
3.5
通讯作者：
Hasler, WL
中科院分区：
文献类型：
--
作者：
Coleski, R;Hasler, WL
正常和节律失常慢波在不同胃区的频率和幅度特征特征较差。使用内窥镜黏膜标测图，我们量化了在对照条件下和使用胰高血糖素时预定部位的慢波频率和功率。12名健康志愿者接受咪达唑仑胃镜检查。双极记录电极沿大弯和小弯分别指向幽门近端12、7和2 cm处。各部位主频为2.96+/-0.07周次/分(-1)(Cpm)。主频功率在距幽门12 cm处较距幽门2 cm处低59+/-7%(P<；0.01)，但在较大和较小弯曲处的功率相似。静脉注射胰高血糖素(0.3 mg)可降低优势频率(1.40+/-0.10cpm，P<；0.01)，并引起功率降低(12 cm处36+/-37%，2 cm处79+/-20%，P<；0.01)。比较胃粘膜记录和胃电记录的主要频率，发现最小的慢波去耦合。总而言之，在正常情况下，内窥镜粘膜标测显示从近端到远端胃的慢波功率梯度。胰高血糖素以最小程度的解偶联引起胃动过缓，并对慢波功率产生抑制作用，而慢波功率在远端胃窦作用更强。该方法为研究胃慢波节律失常刺激的作用机制提供了新的思路。
Frequency and amplitude characteristics of normal and dysrhythmic slow waves in different gastric regions are poorly characterized. Using endoscopic mucosal mapping, we quantified slow wave frequency and power at predetermined sites under control conditions and with glucagon. Twelve healthy volunteers underwent gastroscopy with midazolam. Bipolar recording electrodes were directed to 12, 7, and 2 cm proximal to the pylorus along the greater and lesser curvatures. Dominant frequencies at all sites were 2.96 +/- 0.07 cycles min(-1) (cpm). Powers of the dominant frequency were 59 +/- 7% lower 12 cm vs 2 cm from the pylorus (P < 0.01), but were similar along the greater and lesser curvatures. Glucagon (0.3 mg IV) decreased dominant frequencies (1.40 +/- 0.10 cpm, P < 0.01) and elicited power reductions which varied by region (36 +/- 37% at 12 cm vs 79 +/- 20% at 2 cm, P < 0.01). Comparing dominant frequencies from mucosal recordings and electrogastrography revealed minimal slow wave uncoupling. In conclusion, endoscopic mucosal mapping demonstrates slow wave power gradients from the proximal to distal stomach under normal conditions. Glucagon evokes bradygastria with minimal uncoupling and elicits inhibitory effects on slow wave power which are more potent in the distal antrum. This method provides insight into the mechanisms of action of gastric slow wave dysrhythmic stimuli.