Merrouche M, Accary J P, Rigaud D, Vallot T, Vatier J, Mignon M
Service d'Hépato-Gastroentérologie, Hôpital Bichat, Paris.
Gastroenterol Clin Biol. 1989 Oct;13(10):793-8.
Duodenal ulcer is a recurrent disease with seasonal periodicity for pain and complications such as hemorrhage and perforation. Ulcer craters or symptoms seem to occur preferentially in early spring and autumn. Since acid secretion is one of the pathogenetic factors of the disease, we analyzed retrospectively basal and maximal (pentagastrin) acid secretion data obtained in 341 consecutive patients according to the month in which they were obtained. The patients were classified according to the activity of their ulcer (active, non active) and to the level of the peak acid secretion (hypersecretors, normosecretors). Basal acid concentration and output, and peak acid output were, both overall and month by month, higher in patients with active duodenal ulcer disease than in those who were non active, and in hypersecretors than in normosecretors. For all 341 patients as well as for normosecretors and non active ulcer patients, a triannual rhythm was detected for stimulated acid concentration and peak acid output. The highest values were noted in February, June, and October (period: 4 months). The amplitude of these rhythms was 3 to 4 percent, with differences between highest and lowest values of 30.4 mmol/l for concentration and 17.1 mmol/h for peak acid output. These rhythms for acid secretion during the year may contribute to the periodicity of duodenal ulcer events and should be analyzed in association with other factors which could be implied in ulcerogenesis. Moreover, this seasonal periodicity of acid secretion in duodenal ulcer should be taken into account in all therapeutic trials in which acid secretion is analyzed.
十二指肠溃疡是一种具有疼痛季节性周期以及出血、穿孔等并发症的复发性疾病。溃疡病灶或症状似乎在早春和秋季更容易出现。由于胃酸分泌是该疾病的发病因素之一，我们回顾性分析了341例连续患者根据采集月份获得的基础胃酸分泌和最大（五肽胃泌素）胃酸分泌数据。患者根据溃疡活动情况（活动期、非活动期）以及胃酸分泌峰值水平（高分泌者、正常分泌者）进行分类。无论是总体还是逐月来看，活动期十二指肠溃疡患者的基础胃酸浓度和分泌量以及胃酸分泌峰值均高于非活动期患者，高分泌者高于正常分泌者。对于所有341例患者以及正常分泌者和非活动期溃疡患者，刺激后胃酸浓度和胃酸分泌峰值均检测到每三年一次的节律。最高值出现在2月、6月和10月（周期为4个月）。这些节律的幅度为3%至4%，浓度最高值与最低值之间的差异为30.4 mmol/l，胃酸分泌峰值差异为17.1 mmol/h。一年中胃酸分泌的这些节律可能导致十二指肠溃疡事件的周期性，应结合溃疡发生过程中可能涉及的其他因素进行分析。此外，在所有分析胃酸分泌的治疗试验中，都应考虑十二指肠溃疡胃酸分泌的这种季节性周期。
