Gerolami A, Marteau C, Matteo A, Sahel J, Portugal H, Pauli A M, Pastor J, Sarles H
INSERM U. 250, Faculté de Medecine, Hôpital Sainte-Marguerite, Marseille, France.
Gastroenterology. 1989 Mar;96(3):881-4.
Saturation with calcium carbonate was measured in human pancreatic juice anaerobically collected for diagnostic purposes in 15 patients who were ultimately found not to have pancreatic disease. Bicarbonate, PCO2, proteins, and total and ionized calcium were measured in samples collected every minute during a 20-min period after intravenous administration of secretin (1 U/kg) and, 10 min later, caerulein (75 ng/kg). All samples were supersaturated with calcium carbonate. The first sample (washing-out sample) contained the highest concentrations of ionized calcium (Ca2+) and proteins but was least supersaturated with calcium carbonate. Washing-out samples also differed significantly from samples under caerulein by having a lower pH (7.52 +/- 0.30) and higher PCO2 (103.1 +/- 32.20 mmHg) versus 8.22 +/- 0.15 and 38.4 +/- 4.5 mmHg, respectively. Values of PCO2 increased and bicarbonate concentration decreased linearly with protein concentration in washing-out samples but not under hormonal stimulation. This suggests that a concentration of pancreatic juice occurs in pancreatic ducts in association with luminal H+ secretion and CO2 formation, which results from bicarbonate neutralization. During stimulation, ionized calcium concentration increased with protein concentration without any change of PCO2, so that supersaturation was more pronounced under caerulein than under secretin stimulation. Disturbances of the ductal concentration of pancreatic juice during interdigestive periods could be important for pancreatic stone formation in humans.
对15例最终被诊断无胰腺疾病的患者，为诊断目的而厌氧采集的人胰液进行碳酸钙饱和度测定。在静脉注射促胰液素（1 U/kg）后20分钟内，每分钟采集样本，测定碳酸氢盐、PCO2、蛋白质、总钙和离子钙，10分钟后注射雨蛙素（75 ng/kg）。所有样本的碳酸钙均呈过饱和状态。第一个样本（洗脱样本）的离子钙（Ca2+）和蛋白质浓度最高，但碳酸钙过饱和度最低。洗脱样本的pH值（7.52±0.30）较低，PCO2（103.1±32.20 mmHg）较高，而雨蛙素作用下的样本pH值和PCO2分别为8.22±0.15和38.4±4.5 mmHg，两者也有显著差异。在洗脱样本中，PCO2值随蛋白质浓度呈线性增加，碳酸氢盐浓度随蛋白质浓度呈线性下降，但在激素刺激下则不然。这表明胰液在胰管内的浓缩与管腔内H+分泌和二氧化碳形成有关，而二氧化碳形成是由碳酸氢盐中和产生的。在刺激过程中，离子钙浓度随蛋白质浓度增加，PCO2无变化，因此雨蛙素刺激下的过饱和度比促胰液素刺激下更明显。消化间期胰液导管内浓缩的紊乱可能对人类胰腺结石形成具有重要意义。
