Fiddian-Green R G, Bank S, Marks I N, Louw J H
Lancet. 1976 Dec 25;2(8000):1367-9. doi: 10.1016/s0140-6736(76)91915-2.
The relationship between the capacity to secrete acid and the risk of peptic ulcer has been examined prospectively in 114 healthy symptom-free students and retrospectively in 2361 patients with and without ulcers. The risk of ulcer was found to increase as te maximum acid output (M.A.O.) increased, and the risk of recurrent ulceration, after vagotomy and drainage for duodenal ulceration, was found to increase as the postvagotomy M.A.O. increased. The risk of recurrent ulcer, at any postvagotomy M.A.O., was always greater than the risk of ulceration in a healthy individual with an equivalent M.A.O.. The addition of an antrectomy to a vagotomy restored the risk of recurrent ulcer towards that of a healthy individual developing his first ulcer. The therapeutic benefit of adding an antrectomy to a vagotomy could not be attributed solely to its enhancement of the percentage reduction in M.A.O. from 65% to 95%. The major therapeutic effect of an antrectomy seems to be achieved independently of its action on M.A.O.
对114名无症状的健康学生进行了前瞻性研究，以探讨胃酸分泌能力与消化性溃疡风险之间的关系，并对2361例有或无溃疡的患者进行了回顾性研究。发现溃疡风险随着最大胃酸分泌量（M.A.O.）的增加而增加，并且在十二指肠溃疡行迷走神经切断术和引流术后，复发性溃疡的风险随着迷走神经切断术后的M.A.O.增加而增加。在任何迷走神经切断术后的M.A.O.水平下，复发性溃疡的风险总是高于具有相同M.A.O.的健康个体发生溃疡的风险。在迷走神经切断术基础上加做胃窦切除术，可使复发性溃疡的风险恢复至健康个体发生原发性溃疡的风险水平。在迷走神经切断术基础上加做胃窦切除术的治疗益处不能仅仅归因于其将M.A.O.降低的百分比从65%提高到95%。胃窦切除术的主要治疗效果似乎是独立于其对M.A.O.的作用而实现的。
