Collen M J, Ciarleglio C A, Stanczak V J, Treem W R, Lewis J H
Department of Medicine, Georgetown University School of Medicine, Washington, D.C.
Am J Gastroenterol. 1988 Sep;83(9):923-6.
We investigated basal acid output (BAO) by nasogastric aspiration in 28 children with atypical recurrent abdominal pain, defined as subxyphoid or epigastric pain of more than 3 months duration, associated with vomiting, anorexia, failure to thrive, and/or nocturnal awakening. Twenty-one children had normal upper endoscopies with no esophageal mucosal disease on biopsy, and seven had acid-peptic mucosal disease seen either on endoscopy or on esophageal biopsy. Mean BAO in the children with acid-peptic mucosal disease (6.8 +/- 4.3 mEq/h) was significantly higher than the mean BAO in the children with no mucosal disease (2.4 +/- 1.7 mEq/h) (p less than 0.02). Gastric volumes were also significantly greater in the children with acid-peptic mucosal disease than in children with no mucosal disease (p less than 0.001). There was no significant correlation between body weight and either BAO or basal volume output. Three of seven children with acid-peptic mucosal disease had a BAO greater than two standard deviations above the mean for the group with no mucosal disease. Two of these three had a BAO of more than 10.0 mEq/h (defined as gastric acid hypersecretion in adults), and required higher than usual doses of H2 blocker therapy. These results indicate that the values for BAO in children (greater than 2 yr) are comparable to values recorded in adults. Moreover, measurement of BAO may define a subgroup of children with atypical abdominal pain who are hypersecretors of acid and who require higher doses of antisecretory agents in order to achieve an optimal clinical response.
我们通过鼻胃管抽吸法对28名患有非典型复发性腹痛的儿童进行了基础胃酸分泌量（BAO）的研究。这些儿童的非典型复发性腹痛定义为剑突下或上腹部疼痛持续超过3个月，并伴有呕吐、厌食、生长发育迟缓及/或夜间惊醒。21名儿童上消化道内镜检查正常，活检时食管黏膜无病变，7名儿童在内镜检查或食管活检中发现有酸相关性黏膜疾病。有酸相关性黏膜疾病的儿童的平均基础胃酸分泌量（6.8±4.3毫当量/小时）显著高于无黏膜疾病的儿童（2.4±1.7毫当量/小时）（p<0.02）。有酸相关性黏膜疾病的儿童的胃容量也显著大于无黏膜疾病的儿童（p<0.001）。体重与基础胃酸分泌量或基础容量分泌量之间无显著相关性。7名有酸相关性黏膜疾病的儿童中有3名的基础胃酸分泌量高于无黏膜疾病组平均值的两个标准差。这3名儿童中有2名的基础胃酸分泌量超过10.0毫当量/小时（成人定义为胃酸分泌过多），需要高于常规剂量的H2阻滞剂治疗。这些结果表明，2岁以上儿童的基础胃酸分泌量值与成人记录的值相当。此外，基础胃酸分泌量的测量可能会确定一部分患有非典型腹痛的儿童亚组，他们是胃酸分泌过多者，需要更高剂量的抗分泌药物才能获得最佳临床反应。
