Brady C E, Utts S J, Dev J
Dig Dis Sci. 1987 Mar;32(3):232-8. doi: 10.1007/BF01297046.
The secretin provocation test for gastrinoma is based on the premise that secretin decreases or has no effect on serum gastrin in normal and duodenal ulcer subjects while inducing a paradoxical rise in gastrinoma. We reexamined the serum gastrin response to pharmacologic amounts of secretin in normal volunteers (N = 17) and unoperated duodenal ulcer patients (N = 10). GIH secretin caused significant early gastrin rises from baseline in both groups (P less than 0.05). The gastrin response curves after secretin were not significantly different between normal and ulcer subjects. Similar gastrin rises were seen when synthetic secretin was administered to normal subjects (N = 6). In normal volunteers, intravenous bolus saline (N = 10) or amino acid (L-cysteine, N = 8) caused no change in serum gastrin from baseline. The gastrin response curves to GIH secretin and saline were significantly different (P less than 0.05). Our findings suggest that the gastrin rise in gastrinoma patients after secretin is an exaggeration of the normal response and not paradoxical.
促胰液素可使正常人和十二指肠溃疡患者的血清胃泌素降低或无影响，而在胃泌素瘤患者中却会引起胃泌素反常升高。我们重新研究了正常志愿者（N = 17）和未经手术的十二指肠溃疡患者（N = 10）对药理剂量促胰液素的血清胃泌素反应。胃肠道抑制性多肽（GIH）促胰液素使两组患者的胃泌素均从基线水平显著早期升高（P < 0.05）。正常人和溃疡患者在给予促胰液素后的胃泌素反应曲线无显著差异。当向正常受试者（N = 6）给予合成促胰液素时，也观察到类似的胃泌素升高。在正常志愿者中，静脉推注生理盐水（N = 10）或氨基酸（L-半胱氨酸，N = 8）未使血清胃泌素相对于基线水平发生变化。GIH促胰液素和生理盐水的胃泌素反应曲线有显著差异（P < 0.05）。我们的研究结果表明，促胰液素后胃泌素瘤患者的胃泌素升高是正常反应的过度表现，而非反常现象。
