Hyman P E, Everett S L, Harada T
J Pediatr Gastroenterol Nutr. 1986 Mar-Apr;5(2):191-7.
To determine the frequency of gastric acid hypersecretion in infants with chronic malabsorption due to short bowel syndrome, acid secretory function was determined in 23 infants with malabsorption 2-22 months following small bowel resection and in a control group of 14 chronically ill, age- and weight-matched infants who did not undergo bowel resection. The prevalence of basal acid hypersecretion (defined as acid output 2 SD above the mean for the control group) was 17% (4 of 23). Basal gastric acid hypersecretion was associated with two factors: massive small bowel resection and initiation of enteral feeding. Basal acid hypersecretion was present on the initial study in 3 of 7 infants with less than one-third of the small bowel remaining, but in only 1 of 16 with more than one-third intact (p less than 0.05). Hypergastrinemia was present in 3 of 6 infants following massive bowel resection, but in only 1 of 15 with more than one-third intact (p less than 0.05), but hypergastrinemia was not consistently associated with hypersecretion. In each of six previously unfed infants, a trial of enteral feeding resulted in increased basal and maximal acid output. Three infants developed basal acid hypersecretion during initiation of enteral feeding. There was no evidence of pentagastrin-stimulated maximal acid hypersecretion in any of the infants.
为确定短肠综合征所致慢性吸收不良婴儿胃酸分泌过多的发生率，对23例小肠切除术后2至22个月的吸收不良婴儿以及14例未接受肠切除、年龄和体重匹配的慢性病婴儿对照组进行了酸分泌功能测定。基础胃酸分泌过多（定义为酸排出量高于对照组均值2个标准差）的发生率为17%（23例中有4例）。基础胃酸分泌过多与两个因素有关：大量小肠切除和开始肠内喂养。在最初的研究中，剩余小肠不足三分之一的7例婴儿中有3例存在基础胃酸分泌过多，但小肠完整超过三分之一的16例婴儿中只有1例出现（p<0.05）。大量肠切除术后的6例婴儿中有3例出现高胃泌素血症，但小肠完整超过三分之一的15例婴儿中只有1例出现（p<0.05），但高胃泌素血症与分泌过多并非始终相关。在6例之前未进行喂养的婴儿中，每例进行肠内喂养试验后基础酸排出量和最大酸排出量均增加。3例婴儿在开始肠内喂养期间出现基础胃酸分泌过多。在任何婴儿中均未发现五肽胃泌素刺激的最大胃酸分泌过多的证据。
