Hayakawa Toshihiko, Kaneko Hiroshi, Konagaya Toshihiro, Shinozaki Kaori, Kasahara Akihito, Funaki Yasushi, Mori Shozaburo, Yokoi Takio, Hirooka Yoshifumi, Kusugami Kazuo, Kakumu Shinichi
Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi Cancer Center Hospital, Japan.
J Gastroenterol Hepatol. 2003 May;18(5):505-11. doi: 10.1046/j.1440-1746.2003.03008.x.
Antral somatostatin interacts with gastric acid secretion. We aimed to investigate the effect of eradication on gastric acid, somatostatin secretion and mucosal histology in gastric ulcer patients with Helicobacter pylori (H. pylori) infection.
Twenty-eight patients (21 male, 7 female) with H. pylori-positive gastric ulcer were treated with dual therapy. Before and 4-8 weeks after the therapy, the histology of biopsy specimens, basal acid output (BAO) and maximal acid output (MAO) after stimulation with tetragastrin were assessed. Somatostatin concentration in the gastric juice was measured by radioimmunoassay, and somatostatin output during either the basal or gastrin-stimulated period was also examined.
Eradication was successful in 22 patients. Before treatment, the acid and somatostatin output were inversely related to the severity of neutrophil infiltration in the corpus and antrum, respectively. After successful eradication, improvement of histological inflammation and an increase in BAO, basal and gastrin-stimulated somatostatin output were observed. Eradication had no effect on atrophy and MAO. There was a positive correlation between gastric acid and somatostatin output in the basal or stimulated condition, irrespective of H. pylori infection.
The present results suggest that recovery of gastric BAO may be caused by an improvement in corpus neutrophil infiltration, but not by an increase in parietal cell volume or a change in atrophy. Also, there was an increase in basal and gastrin-stimulated somatostatin-containing cell activity accompanied by improved antral neutrophil infiltration in the early phase after H. pylori eradication in gastric ulcers.
胃窦部生长抑素与胃酸分泌相互作用。我们旨在研究根除幽门螺杆菌(H. pylori)感染对胃溃疡患者胃酸、生长抑素分泌及黏膜组织学的影响。
28例H. pylori阳性胃溃疡患者(21例男性,7例女性)接受了双联疗法治疗。在治疗前及治疗后4 - 8周,评估活检标本的组织学、经五肽胃泌素刺激后的基础酸排量(BAO)和最大酸排量(MAO)。采用放射免疫分析法测定胃液中生长抑素浓度,并检测基础期或胃泌素刺激期的生长抑素分泌量。
22例患者根除成功。治疗前,酸分泌量和生长抑素分泌量分别与胃体和胃窦部中性粒细胞浸润程度呈负相关。根除成功后,观察到组织学炎症改善,BAO增加,基础期和胃泌素刺激期生长抑素分泌量增加。根除对萎缩和MAO无影响。无论是否感染H. pylori,基础状态或刺激状态下胃酸分泌量与生长抑素分泌量均呈正相关。
目前的结果表明,胃BAO的恢复可能是由于胃体部中性粒细胞浸润改善所致,而非壁细胞体积增加或萎缩改变所致。此外,在胃溃疡患者根除H. pylori后的早期,基础期和胃泌素刺激期含生长抑素细胞的活性增加,同时胃窦部中性粒细胞浸润改善。