Milito G, Taccone-Gallucci M, Brancaleone C, Nardi F, Filingeri V, Cesca D, Casciani C U
Am J Gastroenterol. 1983 Jun;78(6):328-31.
Seventy-five dialysis patients awaiting renal transplantation were studied. Investigations included single contrast barium meal, serum gastrin assay, gastric acid studies, and fiberoptic gastroduodenoscopy with multiple biopsies. Radiological studies revealed five duodenal ulcers and one gastric ulcer. Endoscopy showed gastroduodenal lesions in 57 patients (49%). Superficial gastritis was present in 50 patients (66.7%), atrophic gastritis in 11 (14.6%), and duodenitis in 30 (40%). Hypergastrinemia was observed in 48 patients (64%). Maximum acid output was markedly elevated in 33 patients. Acid hypersecretion was found to be correlated with the presence of endoscopic lesions and histological evidence of gastritis. Nine of the 11 patients with atrophic gastritis were acid hyposecretors and had low gastrin levels. Pretransplant gastric assessment identified a relevant number of gastroduodenal lesions in these patients. The increased risk of severe posttransplant ulceration justifies thorough gastric assessment and prophylactic antiulcer therapy in all renal transplant candidates.
对75名等待肾移植的透析患者进行了研究。检查项目包括单对比钡餐检查、血清胃泌素测定、胃酸研究以及纤维光学胃十二指肠镜检查并多次活检。放射学研究发现5例十二指肠溃疡和1例胃溃疡。内镜检查显示57例患者（49%）存在胃十二指肠病变。50例患者（66.7%）有浅表性胃炎，11例（14.6%）有萎缩性胃炎，30例（40%）有十二指肠炎。48例患者（64%）观察到高胃泌素血症。33例患者的最大酸分泌量明显升高。发现胃酸分泌过多与内镜病变的存在以及胃炎的组织学证据相关。11例萎缩性胃炎患者中有9例胃酸分泌过少且胃泌素水平较低。移植前的胃部评估发现这些患者中有相当数量的胃十二指肠病变。移植后发生严重溃疡的风险增加，这证明对所有肾移植候选者进行全面的胃部评估和预防性抗溃疡治疗是合理的。
