Fiddian-Green R G, Stanley J C, Nostrant T, Phillips D
Division of General Surgery, University of Massachusetts Medical Center, Worcester.
J Cardiovasc Surg (Torino). 1989 Sep-Oct;30(5):852-9.
Acidosis in gastric mucosa (pHi less than 7.32) was evaluated as a diagnostic test for gastric ischemia, using 80 asymptomatic subjects as controls. Mucosal acidosis was found in 6 patients with abdominal pain and 1 with gastrointestinal bleeding. Three had occlusive disease of 2 or more visceral arteries, 3 had occlusive disease of the celiac axis alone, and 1 had an occluded portal vein. One patient had infarcted gut. The abnormal pHi (7.10 +/- 0.11, mean +/- SD) in those with pain was returned to normal levels (7.43 +/- 0.08, p = 0.0003) and the symptoms relieved by revascularization. The abnormal pHi (6.84 +/- .04) in the patient who bled was restored to normal levels (7.48 +/- .03, t = 9.69, p less than .0001) and the bleeding stopped by a central splenorenal shunt. Measurements of pHi in gastrointestinal mucosa may be used as an objective test for evaluating patients suspected of having chronic gastrointestinal ischemia.
以80名无症状受试者作为对照，评估胃黏膜酸中毒（胃内pH值低于7.32）作为胃缺血的诊断试验。6例腹痛患者和1例胃肠道出血患者存在黏膜酸中毒。其中3例有2支或更多内脏动脉闭塞性疾病，3例仅有腹腔干闭塞性疾病，1例门静脉闭塞。1例患者肠道梗死。疼痛患者的异常胃内pH值（7.10±0.11，均值±标准差）恢复至正常水平（7.43±0.08，p = 0.0003），症状通过血管重建得以缓解。出血患者的异常胃内pH值（6.84±0.04）恢复至正常水平（7.48±0.03，t = 9.69，p＜0.0001），通过脾肾中央分流术出血停止。胃肠道黏膜胃内pH值测量可作为评估疑似慢性胃肠道缺血患者的客观试验。
