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Human duodenogastric reflux, retroperistalsis, and MMC.

机译:人十二指肠胃反流,后蠕动和MMC。

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The aim of this study was to determine to what extent human migrating motor complex (MMC)-related secretory phenomena are influenced by a recently discovered period of duodenal retroperistalsis during late phase III. A constant-flow perfusion technique was used to measure gastric appearance of acid, bicarbonate, pepsin, bilirubin, IgA, and duodenally infused [14C]polyethylene glycol (PEG) 4000 in 12 healthy volunteers. Interdigestive gastroduodenal motility was recorded by digital manometry. During late antral phase II and III, the gastric lumen was acidified (P < 0.005 phase III vs. phase I) together with a marked increase in luminal pepsin output (3.1 +/- 1.2 during phase III vs. 0.25 +/- 0.08 kU/5 min in phase I, P < 0.01), followed by a realkalinization due to a simultaneous reduction of acid secretion and a duodenogastric reflux, aided by retrograde peristalsis, of bicarbonate and IgA but not of bilirubin, at the end of antral phase III (P < 0.05 phase III vs. phase I values). This physiological duodenoantral reflux phenomenon may play an important role in the chemical and immunological restitution of the antral mucosal barrier function after the exposure to high acid and pepsin concentrations during antral phase III activity.
机译:这项研究的目的是确定与人类迁徙运动复合物(MMC)相关的分泌现象在多大程度上受第三期晚期十二指肠后蠕动的影响。在12名健康志愿者中,使用恒流灌注技术测量了胃酸,碳酸氢根,胃蛋白酶,胆红素,IgA和十二指肠灌注的[14C]聚乙二醇(PEG)4000的外观。用数字测压法记录消化内十二指肠蠕动。在胃窦II期和III期晚期,胃腔被酸化(III期相对于I期,P <0.005),胃蛋白酶的输出显着增加(III期为3.1 +/- 1.2 vs. 0.25 +/- 0.08 kU I期/ 5分钟,P <0.01),然后由于在胃窦III期结束时碳酸氢盐和IgA的酸分泌减少和十二指肠胃逆流(在逆行蠕动的帮助下)而发生了实碱化,而胆红素则不然(P <0.05,III期vs. I期值)。这种生理性十二指肠返流现象在III期窦房颤活动期间暴露于高浓度的胃蛋白酶和胃液中后,可能在化学和免疫恢复窦房黏膜屏障功能中起重要作用。

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