Fisher A A, Shevchenko O A
Ter Arkh. 1987;59(12):71-5.
The time course of the levels of glycemia, gastric secretion of acid and pepsin, and indices of variation pulsometry in response to intravenous injection of glucose (0.66 g/kg) was studied in 42 patients with duodenal ulcer and in 11 healthy persons. It was established that in duodenal ulcer the reactivity of the central glucoreceptor mechanism regulating acid and pepsin secretion, was considerably elevated, especially in patients with complicated forms of disease and gastric hypersecretion. A hyperglycemia-induced degree of acid and pepsin secretion suppression was 1.5- 2-fold higher in the study group than in the control group. The authors proposed that the ratio of a degree of a decrease in acid production (delta % AP) and pepsin production (delta % PP) to the level of glycemia increment (delta % Gl)--acid-glucose (delta % AP/delta % Gl) and pepsin-glucose (delta % PP/delta % Gl) indices should be calculated for overall assessment of a reaction to hyperglycemia of the hypothalamic glucose sensitive mechanism of gastric secretion regulation. These indices reflected a degree of hypothalamic dysfunctions and could serve as markers of the gravity of disease. In the patients with uncomplicated duodenal ulcer as compared to the control group, the acid-glucose index was 2.6-fold and the pepsin-glucose index 1.6-fold higher, and in the patients with complicated duodenal ulcer the indices were 4.6- and 2.9-fold higher, respectively; the indices were higher in the patients with basal acid hypersecretion and hyperplasia of parietal cells.
对42例十二指肠溃疡患者和11名健康人进行了研究，观察静脉注射葡萄糖（0.66 g/kg）后血糖水平、胃酸和胃蛋白酶分泌以及脉搏波测量变化指标随时间的变化过程。结果发现，十二指肠溃疡患者中调节胃酸和胃蛋白酶分泌的中枢葡萄糖受体机制的反应性显著升高，尤其是在疾病复杂形式和胃酸分泌过多的患者中。研究组高血糖诱导的胃酸和胃蛋白酶分泌抑制程度比对照组高1.5至2倍。作者建议计算胃酸分泌减少程度（δ%AP）和胃蛋白酶分泌减少程度（δ%PP）与血糖升高水平（δ%Gl）的比值——酸-葡萄糖（δ%AP/δ%Gl）和胃蛋白酶-葡萄糖（δ%PP/δ%Gl）指标，以全面评估胃分泌调节的下丘脑葡萄糖敏感机制对高血糖的反应。这些指标反映了下丘脑功能障碍的程度，可作为疾病严重程度的标志物。与对照组相比，单纯十二指肠溃疡患者的酸-葡萄糖指数高2.6倍，胃蛋白酶-葡萄糖指数高1.6倍；复杂十二指肠溃疡患者的这些指标分别高4.6倍和2.9倍；基础胃酸分泌过多和壁细胞增生患者的这些指标更高。
