Lamers C B, Rotter J I, Jansen J B
Department of Gastroenterology and Hepatology, University Hospital, Leiden, The Netherlands.
Gut. 1988 Oct;29(10):1358-63. doi: 10.1136/gut.29.10.1358.
Recent studies have suggested that patients with multiple endocrine neoplasia type I (MEN I) may have abnormal serum gastrin secretion in the absence of gastrin producing tumours. G-(gastrin) cell function by three provocation tests in 20 patients with hyperparathyroidism from six MEN I-families were studied: each patient was an obligate carrier of the MEN I-gene. The serum gastrin response to secretin was used to identify the presence of gastrinoma, that to a test meal of G-cell hyperfunction of the antral and/or duodenal mucosa, and that to bombesin to differentiate antral from duodenal G-cell hyperfunction. Seven patients had basal hypergastrinaemia and hyperchlorhydria. These patients had increased serum gastrin responses to secretin (p less than 0.01) and to bombesin (p less than 0.02), but normal postprandial responses. In the 13 normogastrinaemic patients the responses to the three stimuli were normal. In families with MEN-I gastrinoma is the only endocrine disorder accounting for abnormal gastrin secretion. G-cell function is normal in obligate carriers of the MEN I-gene.
近期研究表明,Ⅰ型多发性内分泌腺瘤病(MEN I)患者在无胃泌素产生肿瘤的情况下,可能存在血清胃泌素分泌异常。对来自6个MEN I家系的20例甲状旁腺功能亢进患者进行了三项激发试验,以研究G(胃泌素)细胞功能:每位患者均为MEN I基因的必然携带者。用血清胃泌素对促胰液素的反应来确定胃泌素瘤的存在,用对试餐的反应来判断胃窦和/或十二指肠黏膜G细胞功能亢进,用对蛙皮素的反应来区分胃窦与十二指肠G细胞功能亢进。7例患者有基础高胃泌素血症和胃酸过多。这些患者血清胃泌素对促胰液素的反应增强(p<0.01),对蛙皮素的反应也增强(p<0.02),但餐后反应正常。在13例胃泌素正常的患者中,对三种刺激的反应均正常。在MEN - I家系中,胃泌素瘤是导致胃泌素分泌异常的唯一内分泌疾病。MEN I基因的必然携带者G细胞功能正常。