Naito H, Sasaki I, Funayama Y, Kamiyama Y, Matsuno S, Sato T
First Department of Surgery, Tohoku University School of Medicine, Sendai.
Tohoku J Exp Med. 1988 Jul;155(3):295-301. doi: 10.1620/tjem.155.295.
We evaluated the incidence of associated peptic ulcers and the gastric acid secretion in our 20 series of insulinoma, and obtained the following results: 1) Four out of 20 patients (20%) with insulinoma were associated with peptic ulcers. 2) Except for the maximum acid concentration, the preoperative gastric secretion tests, such as the basal acid output and maximum acid output, failed to indicate hyperacidity in those patients. And patients with a short duration of illness by insulinoma neither showed hyperacidity nor were associated with peptic ulcers. 3) A tendency of reduced gastric acid secretion and the amelioration of peptic ulcers was observed in those who underwent the extirpation of insulinoma. 4) In the most recent case received gastric analysis with continuous monitoring of blood glucose level, an increase of basal acid output was observed during the hypoglycemic period in which the blood glucose levels reduced to around 30 mg/100 ml. These results indicate that the low blood glucose level and the high gastric acid secretion produced under the condition on an empty stomach, may be important factors related to the high association rates of the peptic ulcers in patients with insulinoma.
我们评估了20例胰岛素瘤患者中合并消化性溃疡的发生率及胃酸分泌情况，结果如下：1）20例胰岛素瘤患者中有4例（20%）合并消化性溃疡。2）除最大胃酸浓度外，术前胃酸分泌试验，如基础胃酸排出量和最大胃酸排出量，均未显示这些患者胃酸过多。胰岛素瘤病程短的患者既未出现胃酸过多，也未合并消化性溃疡。3）在接受胰岛素瘤切除的患者中，观察到胃酸分泌减少和消化性溃疡改善的趋势。4）在最近一例同时进行胃液分析和血糖水平持续监测的病例中，在血糖水平降至约30mg/100ml的低血糖期，基础胃酸排出量增加。这些结果表明，空腹状态下产生的低血糖水平和高胃酸分泌，可能是胰岛素瘤患者消化性溃疡高合并率的重要相关因素。
