Institute of Clinical Medicine, National Cheng Kung University, Tainan 701, Taiwan, China.
World J Gastroenterol. 2010 Nov 21;16(43):5496-501. doi: 10.3748/wjg.v16.i43.5496.
To search the independent factors determining gastric juice acidity and to investigate the acidity of gastric juices in various benign and malignant upper gastrointestinal diseases.
Fasting gastric juice acidity of 165 healthy subjects and 346 patients with esophageal ulcer (n = 21), gastric ulcer (n = 136), duodenal ulcer (n = 100) or gastric cancer (n = 89) were measured and compared. Additionally, gastric specimens were taken from the antrum and body for rapid urease test and histological examination.
Multivariate analysis revealed that bile stain of gastric juice, high acute inflammatory score of the corpus, and atrophy of the corpus were independent risk factors for the development of gastric hypoacidity with odds ratios of 3.1 (95% CI: 1.3-7.3), 3.1 (95% CI: 1.2-7.9) and 3.5 (95% CI: 1.3-9.2). Esophageal ulcer and duodenal ulcer patients had a lower pH level (1.9 and 2.1 vs 2.9, both P < 0.05) of gastric juices than healthy subjects. In contrast, gastric ulcer and gastric cancer patients had a higher pH level (3.4 and 6.6 vs 2.9, both P < 0.001) than healthy controls. Hypoacidity existed in 22%, 5%, 29%, 5% and 88% of healthy subjects, esophageal ulcer, gastric ulcer, duodenal ulcer and gastric cancer patients, respectively.
Bile reflux, atrophy and dense neutrophil infiltrate of the corpus are three independent factors determining the acidity of gastric juice.
探索决定胃液酸度的独立因素，并研究各种良性和恶性上消化道疾病的胃液酸度。
测量 165 名健康受试者和 346 名食管溃疡（n=21）、胃溃疡（n=136）、十二指肠溃疡（n=100）或胃癌（n=89）患者的空腹胃液酸度，并进行比较。此外，从胃窦和胃体取胃标本进行快速尿素酶试验和组织学检查。
多变量分析显示，胃液胆汁染色、胃体高急性炎症评分和胃体萎缩是胃酸分泌减少的独立危险因素，比值比分别为 3.1（95%可信区间：1.3-7.3）、3.1（95%可信区间：1.2-7.9）和 3.5（95%可信区间：1.3-9.2）。与健康受试者相比，食管溃疡和十二指肠溃疡患者的胃液 pH 值较低（分别为 1.9 和 2.1，均 P<0.05）。相反，胃溃疡和胃癌患者的胃液 pH 值较高（分别为 3.4 和 6.6，均 P<0.001）。健康受试者、食管溃疡、胃溃疡、十二指肠溃疡和胃癌患者中分别有 22%、5%、29%、5%和 88%存在低胃酸分泌。
胆汁反流、胃体萎缩和密集中性粒细胞浸润是决定胃液酸度的三个独立因素。
