Van Loon F P, Clemens J D, Shahrier M, Sack D A, Stephensen C B, Khan M R, Rabbani G H, Rao M R, Banik A K
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
J Clin Epidemiol. 1990;43(12):1361-7. doi: 10.1016/0895-4356(90)90103-v.
Although gastric acid is thought to be an important host defense against certain enteric infections, field studies of the role of gastric acid in preventing enteric infections have been hampered by the lack of a suitable non-invasive test. Because low gastric acid output (GAO) is an established risk factor for cholera, we assessed after validation, whether a new non-invasive test which estimates GAO by measuring breath hydrogen excess after ingestion of magnesium and a stimulant of gastric acid secretion, could discriminate between persons at high and at low risk of developing cholera. Fifteen age-matched pairs, participants in the field trial of two oral cholera vaccines in rural Bangladesh, were tested. In each pair the "case" was a person who had recovered from severe cholera at least 6 months before testing and the "control" was a person who resided in the home of a cholera patient but remained uninfected. The stimulated breath hydrogen was higher in controls (median hydrogen excess = 369 mumol/80 min) than in cases (median hydrogen excess = 150 mumol/80 min) (p less than 0.05) and was higher in controls in 12 out of 15 pairs. The results, which are consistent with past invasive assessments of the association between hypochlorhydria and cholera, suggest that this non-invasive test may be useful in evaluating GAO in epidemiological field studies.
尽管胃酸被认为是抵御某些肠道感染的重要宿主防御机制，但由于缺乏合适的非侵入性检测方法，关于胃酸在预防肠道感染中作用的现场研究受到了阻碍。由于低胃酸分泌量（GAO）是霍乱的一个既定危险因素，我们在验证后评估了一种新的非侵入性检测方法，该方法通过测量摄入镁和胃酸分泌刺激剂后呼出氢气过量来估计GAO，是否能够区分患霍乱高风险和低风险的人群。对参与孟加拉国农村两种口服霍乱疫苗现场试验的15对年龄匹配的参与者进行了检测。在每一对中，“病例”是在检测前至少6个月从严重霍乱中康复的人，“对照”是居住在霍乱患者家中但未被感染的人。对照组的刺激后呼出氢气量更高（呼出氢气过量中位数 = 369 μmol/80分钟），高于病例组（呼出氢气过量中位数 = 150 μmol/80分钟）（p < 0.05），15对中有12对对照组更高。这些结果与过去关于胃酸过少与霍乱之间关联的侵入性评估结果一致，表明这种非侵入性检测方法可能有助于在流行病学现场研究中评估GAO。
