Savarino V, Mela G S, Zentilin P, Sumberaz A, Bonifacino G, Gambaro P, Celle G
Istituto Scientifico di Medicina Interna-Cattedra di Gastroenterologia, Università degli Studi di Genova, Italy.
Hepatogastroenterology. 1991 Aug;38(4):299-301.
The circadian pattern of gastric acidity was assessed in 53 normal subjects and in 33 patients with prior cholecystectomy using continuous pH monitoring. The 24-hour and nocturnal median pH values were significantly higher in cholecystectomized patients than in controls (p less than 0.03 and p less than 0.001, respectively). In the operated group there were higher median pHs also in the after-dinner (p less than 0.003) and after-lunch (p less than 0.01) periods, while no difference between the two populations was observed after breakfast. The percentage of 24-hour pH readings above 4.0 units was markedly higher (p approximately 0) in postcholecystectomy patients. We conclude that circadian gastric acidity is reduced in cholecystectomized patients with respect to healthy subjects, both in nocturnal and postprandial states. Episodes of duodenogastric reflux may be responsible for this, but impaired acid production related to advanced age (14 patients were more than 60 years old) or to fundic chronic atrophic gastritis (5 cases) may also account for the elevation of pH values in our postcholecystectomy patients.
采用连续pH监测法对53名正常受试者和33名曾行胆囊切除术的患者的胃酸昼夜模式进行了评估。胆囊切除术后患者的24小时和夜间pH中值显著高于对照组（分别为p<0.03和p<0.001）。在手术组中，晚餐后（p<0.003）和午餐后（p<0.01）时段的pH中值也较高，而早餐后两组人群之间未观察到差异。胆囊切除术后患者24小时pH读数高于4.0单位的百分比明显更高（p约为0）。我们得出结论，胆囊切除术后患者与健康受试者相比，昼夜胃酸度在夜间和餐后状态下均降低。十二指肠胃反流发作可能是造成这种情况的原因，但与高龄（14名患者年龄超过60岁）或胃底慢性萎缩性胃炎（5例）相关的胃酸分泌受损也可能是我们胆囊切除术后患者pH值升高的原因。
