THE SYMPATHETIC NERVOUS-SYSTEM MODULATES PERCEPTION AND REFLEX RESPONSES TO GUT DISTENSION IN HUMANS
THE SYMPATHETIC NERVOUS-SYSTEM MODULATES PERCEPTION AND REFLEX RESPONSES TO GUT DISTENSION IN HUMANS
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DOI：
10.1016/0016-5085(95)90439-5
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发表时间：
1995-03-01
期刊：
影响因子：
29.4
通讯作者：
MALAGELADA, JR
中科院分区：
文献类型：
--
作者：
IOVINO, P;AZPIROZ, F;MALAGELADA, JR
背景/目标：肠扩张通过交感神经和迷走神经通路诱导感知和肠反射，但这些反应的调节机制仍不清楚。本研究的目的是确定交感神经活动对交感神经和迷走神经反射以及对肠道和躯体感知的影响。研究方法：在9名健康志愿者中，以4 mL增量产生近端十二指肠扩张，以3 mA增量产生手部经皮电神经刺激。以10分钟的间隔随机进行持续时间为1分钟的递增刺激，有和没有交感神经激活（通过下体负压诱导）。肠和躯体知觉进行了具体的问卷调查，迷走神经肠胃和交感神经肠舒张反射，同时测量胃和十二指肠远端恒压器。结果如下：交感神经激活显著提高了对肠扩张的感知，而没有改变对躯体刺激的感知（感知评分分别增加了41%和-2%）。在胃和肠的交感神经激活期间，对十二指肠扩张的反射反应显著增加（舒张分别增加91%和69%;两者P < 0.05）。结论：交感神经系统的激活选择性地增加内脏而非躯体敏感性，并增强肠道中迷走和交感神经驱动的反射。
Background/Aims: Intestinal distention induces perception and gut reflexes via sympathetic and vagal pathways, but the modulatory mechanisms of such responses remain obscure. The aim of this study was to determine the effects of sympathetic nervous activity on sympathetic and vagal reflexes as well as on intestinal and somatic perception. Methods: In 9 healthy volunteers, proximal duodenal distentions were produced in 4-mL increments and hand transcutaneous electrical nerve stimulation was produced in 3-mA increments. increasing stimuli of 1-minute duration were randomly performed at 10-minute intervals both with and without sympathetic activation (induced by means of lower body negative pressure). Intestinal and somatic perception was scored by specific questionnaires; vagal enterogastric and sympathetic intestinointestinal relaxatory reflexes were simultaneously measured by gastric and distal duodenal barostats. Results: Sympathetic activation significantly heightened perception of intestinal distention without modifying perception of somatic stimuli (perception scores increased by 41% and -2%, respectively). The reflex responses to duodenal distention significantly increased during sympathetic activation both in the stomach and in the intestine (relaxation increased by 91% and 69%, respectively; P < 0.05 for both). Conclusions: Activation of the sympathetic nervous system selectively increases visceral but not somatic sensitivity and enhances both vagally and sympathetically driven reflexes in the gut.