George A A, Tsuchiyose M, Dooley C P
Division of Gastrointestinal and Liver Diseases, University of Southern California School of Medicine, Los Angeles.
Gastroenterology. 1991 Jul;101(1):3-6. doi: 10.1016/0016-5085(91)90453-r.
Nonulcer dyspepsia is a common clinical syndrome whose etiology is unknown. The sensitivity of the gastric mucosa to acid and duodenal contents in 18 patients with nonulcer dyspepsia was studied. The patients had a normal upper gastrointestinal endoscopy and biopsy specimens were obtained for determination of Helicobacter pylori status. Fifteen of the 18 patients were infected with H. pylori. All patients underwent intubation with double-lumen tube and collection of cholecystokinin-stimulated pancretico-biliary secretions. Subsequently, normal saline, 0.1N hydrochloric acid, and autologous duodenal secretions were infused into the stomach in a randomized blinded fashion. A positive response was defined as the production of epigastric pain by acid and/or bile but not by saline. By this definition, only 6 patients (33%) had a positive response and none had reproduction of their usual symptoms. In patients with a negative response, only 4 remained asymptomatic during all infusions. The remaining 8 had symptoms during infusion of saline, 7 of whom also had symptoms during infusion of acid and/or duodenal secretions. Two of these patients had reproduction of their usual symptoms. In conclusion, the gastric mucosa in patients with nonulcer dyspepsia is not abnormally sensitive to acid or duodenal contents.
非溃疡性消化不良是一种病因不明的常见临床综合征。研究了18例非溃疡性消化不良患者胃黏膜对酸和十二指肠内容物的敏感性。这些患者的上消化道内镜检查结果正常，并获取了活检标本以确定幽门螺杆菌状态。18例患者中有15例感染了幽门螺杆菌。所有患者均通过双腔管插管并收集胆囊收缩素刺激后的胰胆分泌物。随后，以随机盲法将生理盐水、0.1N盐酸和自体十二指肠分泌物注入胃内。阳性反应定义为酸和/或胆汁诱发上腹部疼痛，但生理盐水不会诱发。根据这一定义，只有6例患者（33%）有阳性反应，且无人再现其通常症状。在反应阴性的患者中，只有4例在所有输注过程中无症状。其余8例在输注生理盐水期间出现症状，其中7例在输注酸和/或十二指肠分泌物期间也出现症状。这些患者中有2例再现了其通常症状。总之，非溃疡性消化不良患者的胃黏膜对酸或十二指肠内容物并无异常敏感。
