Normal and abnormal motor function of human sphincter of Oddi

评估Oddi括约肌(SO)的运动性对于诊断胆总管十二指肠交界处的病理状态是功能性的还是器质性的很重要。1)Oddi括约肌运动功能测压仪和运动功能测定：我们研制了一种简单、易用的输液系统，它由一个普通的静脉注射组成。泵连接高阻止回阀，用于动脉测压(INTRAFO)。该系统在SO测压方面的性能可与液压毛细血管输液系统或压力导管换能器相媲美。经PTCD途径留置输液导管效果最佳。CCK的应用和Oddi括约肌的运动：静脉注射0.2-0.3U/kg/min的CCK-3310min，可使血浆CCK水平升高至30-50pg/ml(对照组：低于7.5)。在…开始静脉滴注CCK-33后8~10分钟以上。SO运动活动，无论是收缩力还是频率，都被显著抑制，低至对照组的10-0%。抑制持续了近15分钟。而在CCK-33开始后15~20min，胆囊收缩强烈，收缩最大。结论：SO和GB对CCK产量和胆汁排出的有效驱动力是相互作用的。3)消化间期Oddi括约肌的运动：SO运动与十二指肠运动同步。虽然没有一致的观察，但SO收缩3-4次/分钟，即使在十二指肠I期，这表明SO运动活动可能从根本上独立于十二指肠。在十二指肠二期和二期，SO收缩暂时与十二指肠收缩高度相关，频率为10-12次/分钟。我们的结论是，当我们参考或评估SO的运动功能时，必须清楚地记录空腹状态，无论是消化状态还是消化间期状态，当我们确定SO运动功能时，同时记录十二指肠运动活动是强制性的。较少

An evaluation of the motility of the sphincter of Oddi (SO) is important to diagnose whether a pathologic condition at the choledochoduodenal junction is of a functional or organic variety. For a basic knowledge about the motor function of the SO, we conducted a clinical research works.1) Manometric apparatus and Measurement of Motor Function of the Sphincter of Oddi: We developed a simple and easy-for-use infusion system that consisted of a ordinary i.v. pump connected with a high resistance check valve for arterial manometry (Intralfo). The performance of the system in the SO manometry was comparable to hydraulic-capillary infusion system or pressure catheter transducer. The infusion catheter was best settled via PTCD route. This method made a harmless long-lasting manometric study possible.2) CCK Administration and Motility of the Sphincter of Oddi: An intravenous dosage of 0.2-0.3 U/Kg/min of CCK-33for 10 min enhanced the plasma CCK level up to 30-50 pg/ml (control: below 7.5). at … More 8 to 10 min after the commencement of the intravenous CCK-33. The SO motor activities, both contractile force and frequency, were markedly suppressed to as low as 10-0 % of the control values. The suppression lasted for nearly 15 min. While, the gallbladder (GB) contracted strongly with a maximal contraction at 15-20 min after the beginning of CCK-33. It was concluded that reciprocal responses of the SO and GB to CCK yield and effective driving force for bile discharge.3) Motility of the Sphincter of Oddi during Interdigestive State: The SO motor activity was simultaneously registered with that of the duodenum. Although not consistently observed, the SO contracted 3-4/min even in the period of duodenal phase I, showing that the SO motor activity may be, fundamentally, independent of that of the duodenum. During duodenal phase II and II, the SO contractions were temporarily highly linked to the duodenal contractions with a frequency of 10-12/min. We concluded that fasting state, digestive or interdigestive, must be clearly documented when we refer to or evaluate the motor function of the SO and that a simultaneous recording of the duodenal motor activity is mandatory when we determine the SO motor function. Less