Feldman M
J Clin Gastroenterol. 1981;3(Suppl 2):51-6.
The cause of duodenal ulcer (DU) is unknown, but gastric acid and pepsin must be involved in the pathogenesis of the disorder: (1) Patients with massive acid hypersecretion due to gastrinoma almost develop peptic ulcer, usually duodenal; (2) ordinary DU patients, on the average, secrete much more acid basally and also have larger acid secretory capacities than healthy people; and (3) reduction of gastric acid secretion (e.g., with cimetidine) accelerates DU healing and prevents DU from recurring. Although factors responsible for increased basal acid secretion rates and for increased maximal secretory capacity (parietal cell mass) in many DU patients are not completely understood, it is likely that neural and hormonal factors are involved: The stomachs of some DU patients may be under increased vagal drive in the basal state. Parietal cells of DU patients are more sensitive to the hormone gastrin, which is released by food. In this review, evidence for abnormalities in vagal function and gastrin physiology in DU will be discussed, with emphasis on recent developments.
十二指肠溃疡（DU）的病因尚不清楚，但胃酸和胃蛋白酶必定参与了该疾病的发病机制：（1）因胃泌素瘤导致大量胃酸分泌过多的患者几乎都会发生消化性溃疡，通常为十二指肠溃疡；（2）普通DU患者平均基础胃酸分泌量比健康人多得多，且胃酸分泌能力也更强；（3）降低胃酸分泌（如使用西咪替丁）可加速DU愈合并防止其复发。尽管许多DU患者基础胃酸分泌率增加和最大分泌能力（壁细胞数量）增加的相关因素尚未完全明确，但很可能涉及神经和激素因素：一些DU患者的胃在基础状态下可能受迷走神经驱动增强。DU患者的壁细胞对食物释放的胃泌素更敏感。在本综述中，将讨论DU患者迷走神经功能和胃泌素生理学异常的证据，并重点关注近期进展。
