西咪替丁和丙胺太林对一名系统性肥大细胞增多症患者症状的影响。

The effect of cimetidine and propantheline on the symptoms of a patient with systemic mastocytosis.

作者信息

Achord J L, Langford H

出版信息

Am J Med. 1980 Oct;69(4):610-4. doi: 10.1016/0002-9343(80)90476-3.

Abstract

A 24 year old white woman with a lifelong history of systemic mastocytosis and symptoms of diarrhea and flushing was demonstrated to have a normal gastric analysis and inconsistent steatorrhea. She responded well to oral cimetidine therapy for 11 months. A symptomatic recurrence was controlled with the addition of propantheline. Gastric secretory studies demonstrated cimetidine suppression of both basal acid and basal pepsin secretion, as well as maximal pentagastrin-stimulated acid secretion; suppression of stimulated pepsin secretion was minimal. The combination of cimetidine and propantheline markedly suppressed both peak acid and peak pepsin secretion in response to pentagastrin stimulation. These data support a dominant role of cholinergic mechanisms in the control of gastric pepsin secretion; additional data obtained with maintenance of constant intragastric pH are required for further clarification.

摘要

一名24岁的白人女性，有系统性肥大细胞增多症的终生病史，伴有腹泻和潮红症状，其胃分析正常，但脂肪泻情况不一致。她接受口服西咪替丁治疗11个月，效果良好。加用丙胺太林后，症状复发得到控制。胃分泌研究表明，西咪替丁可抑制基础胃酸和基础胃蛋白酶分泌，以及最大五肽胃泌素刺激的胃酸分泌；对刺激胃蛋白酶分泌的抑制作用最小。西咪替丁和丙胺太林联合使用，可显著抑制五肽胃泌素刺激后的胃酸峰值和胃蛋白酶峰值分泌。这些数据支持胆碱能机制在控制胃蛋白酶分泌中起主导作用；需要通过维持胃内pH值恒定获得更多数据，以进一步阐明。