Ainsworth M A, Kjeldsen J, Olsen O, Christensen P, Schaffalitzky de Muckadell O B
Department of Medical Gastroenterology, Odense University Hospital, Denmark.
Digestion. 1990;47(3):121-9. doi: 10.1159/000200486.
In order to investigate the relation between duodenal mucosal and pancreaticobiliary bicarbonate secretion, we have studied the effect of inhibition of mucosal bicarbonate secretion by indomethacin on the disappearance rate of acid and the concomitant plasma secretin concentrations. 10 healthy subjects were studied twice, with and without indomethacin pretreatment. By means of a double-lumen tube the duodenum was perfused with increasing amounts of acid (0, 3.0, 6.0 and 9.5 mmol/h) and the disappearance rate of acid, pH of duodenal aspirate and plasma secretin were measured. In both experiments nearly all acid, even at the highest acid load, disappeared (pH greater than 6). Inhibition of the duodenal mucosal bicarbonate secretion did not decrease the acid-neutralizing capacity of the human duodenum. In fact, the disappearance rate of acid at the highest acid load was a little greater when mucosal bicarbonate secretion had been inhibited than when not (10.3 +/- 0.5 vs. 9.2 +/- 0.2 mmol/h). The pancreaticobiliary secretion of bicarbonate, as judged by plasma secretin concentrations, increased, however, earlier when mucosal bicarbonate secretion had been inhibited than when not (3.7 vs. 3.0 pmol/l at an acid load of 6.0 mmol/h). This indicates that bicarbonate from the duodenal mucosa normally plays a role in the in lumen neutralization of acid in the human duodenum.
为了研究十二指肠黏膜与胰胆管碳酸氢盐分泌之间的关系，我们研究了吲哚美辛抑制黏膜碳酸氢盐分泌对酸的消失速率及血浆促胰液素浓度的影响。对10名健康受试者进行了两次研究，一次有吲哚美辛预处理，一次没有。通过双腔管向十二指肠灌注逐渐增加量的酸（0、3.0、6.0和9.5 mmol/h），并测量酸的消失速率、十二指肠抽吸物的pH值和血浆促胰液素。在两个实验中，几乎所有的酸，即使在最高酸负荷时，也都消失了（pH大于6）。抑制十二指肠黏膜碳酸氢盐分泌并没有降低人十二指肠的酸中和能力。事实上，在最高酸负荷时，黏膜碳酸氢盐分泌受到抑制时酸的消失速率比未受抑制时略高（10.3±0.5对9.2±0.2 mmol/h）。然而，根据血浆促胰液素浓度判断，当黏膜碳酸氢盐分泌受到抑制时，胰胆管碳酸氢盐分泌比未受抑制时更早增加（在酸负荷为6.0 mmol/h时，分别为3.7对3.0 pmol/l）。这表明十二指肠黏膜中的碳酸氢盐通常在人十二指肠内酸的中和中起作用。
