Corinaldesi R, Stanghellini V, Paparo G F, Paternicò A, Giulia Rusticali A, Barbara L
Istituto di Clinica Medica e Gastroenterologia, Universitá degli Studi di Bologna, Italy.
Dig Dis Sci. 1989 Feb;34(2):251-6. doi: 10.1007/BF01536060.
Gastric acid hypersecretion and accelerated gastric emptying are commonly considered as possible determinants of duodenal ulcer, but the relative frequencies of these gastric dysfunctions have never been evaluated in a homogeneous group of patients. We studied basal and pentagastrin-stimulated gastric acid secretion and gastric emptying of a radiolabeled caloric liquid meal in 99 consecutive male patients with endoscopically proven, active, uncomplicated duodenal ulcers. Compared to matched healthy subjects, ulcer patients presented increased basal and stimulated acid secretion (P less than 0.001). Sixty-nine patients had peak acid output values above the 95% confidence limits of the control population (14.2-30.6 meq/hr). Cigarette smoking was correlated with gastric acid hypersecretion. No significant difference was found between duodenal ulcer patients and controls in mean gastric emptying times. Ulcer patients showed a greater variance of gastric acid secretion and emptying values than healthy subjects. This reflects varied gastrointestinal function among ulcer patients. No significant correlation was found between gastric acid output and gastric emptying times. These findings suggest that gastric acid hypersecretion, but not accelerated gastric emptying of liquids, play a relevant role in the pathogenesis of duodenal ulcer.
胃酸分泌过多和胃排空加速通常被认为是十二指肠溃疡的可能决定因素,但这些胃功能障碍的相对发生率从未在一组同质患者中进行过评估。我们研究了99例经内镜证实为活动性、无并发症十二指肠溃疡的连续男性患者的基础胃酸分泌和五肽胃泌素刺激的胃酸分泌,以及放射性标记的高热量液体餐的胃排空情况。与匹配的健康受试者相比,溃疡患者的基础胃酸分泌和刺激胃酸分泌均增加(P<0.001)。69例患者的胃酸峰值输出值高于对照组人群95%置信区间(14.2 - 30.6毫当量/小时)。吸烟与胃酸分泌过多相关。十二指肠溃疡患者和对照组的平均胃排空时间无显著差异。溃疡患者的胃酸分泌和排空值的变异程度大于健康受试者。这反映了溃疡患者胃肠道功能的差异。胃酸输出与胃排空时间之间未发现显著相关性。这些发现表明,胃酸分泌过多而非液体胃排空加速在十二指肠溃疡的发病机制中起相关作用。