Meyers S, Lieber C S
Gastroenterology. 1976 Feb;70(2):244-7.
Ampicillin was tested with regards to its capacity to reduce gastric ammonia production in basal and betazole-stimulated gastric secretion. A 7-day course of oral ampicillin (4 g per day) reduced basal gastric ammonia concentration from 5.5 +/- 1.4 to 1.8 +/- 0.3 mM and postbetazole ammonia from 4.7 +/- 0.9 to 1.3 +/- 0.3 mM (P less than 0.01) in 7 control subjects. Similar results were obtained after oral neomycin (4 g per day) or intramuscular ampicillin (4 g per day), each given to a separate group of 7 control subjects. In 5 azotemic patients, oral ampicillin treatment resulted in a reduction of ammonia concentration from 16.3 +/- 4.7 to 3.1 +/- 0.7 mM in basal secretion and from 18.3 +/- 8.1 to 2.3 +/- 0.6 mM in betazole-stimulated gastric juice (P less than 0.01). Antibiotic therapy did not alter volume of gastric secretion. Gastric acidity appeared lower in azotemic patients and increased significantly after treatment, indicating that the higher ammonia content could account for at least part of the hypoacidity. Because ampicillin is active orally as well as parenterally and can be readily used in renal failure, it may be of value for the treatment of hepatic encephalopathy, especially in the azotemic patient in whom neomycin is toxic.
对氨苄西林降低基础胃酸分泌和倍他唑刺激胃酸分泌时胃氨生成的能力进行了测试。7名对照受试者接受为期7天的口服氨苄西林治疗（每天4克），基础胃氨浓度从5.5±1.4毫摩尔降至1.8±0.3毫摩尔，倍他唑刺激后的氨浓度从4.7±0.9毫摩尔降至1.3±0.3毫摩尔（P<0.01）。分别对另外7名对照受试者给予口服新霉素（每天4克）或肌肉注射氨苄西林（每天4克），得到了类似结果。在5名氮质血症患者中，口服氨苄西林治疗使基础分泌的氨浓度从16.3±4.7毫摩尔降至3.1±0.7毫摩尔，倍他唑刺激的胃液中氨浓度从18.3±8.1毫摩尔降至2.3±0.6毫摩尔（P<0.01）。抗生素治疗未改变胃酸分泌量。氮质血症患者的胃酸度较低，治疗后显著升高，这表明较高的氨含量可能至少部分解释了胃酸过低的原因。由于氨苄西林口服和注射均有活性，且可在肾衰竭患者中轻易使用，因此它可能对肝性脑病的治疗有价值，尤其是在新霉素有毒性的氮质血症患者中。
