Tolin R D, Boden G, Fisher R S
Dig Dis Sci. 1979 Apr;24(4):296-304. doi: 10.1007/BF01296544.
Lower esophageal sphincter function and gastric acid secretion were studied in a patient with endogenous hyperglucagonemia due to a functioning islet cell carcinoma. Complete resection of the tumor resulted in a fall of the serum concentration of immunoreactive glucagon to a normal level. Pre- and postoperative resting lower esophageal sphincter pressures and lower esophageal sphincter pressure responses to administration of pentagastrin, edrophonium, and bethanechol were unchanged. After surgery, preoperative immunoreactive glucagon concentrations were reproduced by intravenous infusion or intramuscular injection of exogenous glucagon. Lower esophageal sphincter resting pressures and responses to agonists were unchanged. In contrast, glucagon administered at 36 micrograms/kg/hr, which produced a serum concentration of immunoreactive glucagon (32,000 pg/ml) much greater than observed preoperatively (1200 pg/ml), diminished resting lower esophageal sphincter pressure and sphincter responses to pentagastrin, edrophonium, and bethanechol. Similarly, pentagastrin-stimulated gastric acid secretion was unaffected by tumor resection or low-dose glucagon infusion but was decreased at a glucagon infusion rate of 36 micrograms/kg/hr. This series of observations supports the thesis that endogenous glucagon plays no physiological role in the regulation of lower esophageal sphincter pressure or gastric acid secretion.
对一名因功能性胰岛细胞瘤导致内源性高胰高血糖素血症的患者进行了食管下括约肌功能和胃酸分泌的研究。肿瘤完全切除后，免疫反应性胰高血糖素的血清浓度降至正常水平。术前和术后静息食管下括约肌压力以及食管下括约肌对五肽胃泌素、依酚氯铵和氨甲酰甲胆碱给药的压力反应均未改变。术后，通过静脉输注或肌肉注射外源性胰高血糖素可再现术前免疫反应性胰高血糖素浓度。食管下括约肌静息压力和对激动剂的反应未改变。相比之下，以36微克/千克/小时的速度给予胰高血糖素，其产生的免疫反应性胰高血糖素血清浓度（32,000皮克/毫升）远高于术前观察到的浓度（1200皮克/毫升），降低了静息食管下括约肌压力以及括约肌对五肽胃泌素、依酚氯铵和氨甲酰甲胆碱的反应。同样，五肽胃泌素刺激的胃酸分泌不受肿瘤切除或低剂量胰高血糖素输注的影响，但在胰高血糖素输注速率为36微克/千克/小时时降低。这一系列观察结果支持内源性胰高血糖素在食管下括约肌压力或胃酸分泌调节中不发挥生理作用这一论点。
