Debas H T
Am J Surg. 1983 Jul;146(1):51-6. doi: 10.1016/0002-9610(83)90258-1.
The mucosa of the proximal stomach contains a powerful inhibitor of acid secretion and gastrin release. The release of this inhibitor is dependent on intact vagal innervation of the proximal stomach. Thus, proximal gastric vagotomy interferes with the release of the inhibitor. After proximal gastric vagotomy for peptic ulcer, recurrence rates increase over time. In addition, there is some recovery of acid secretion. Although nerve regeneration or sprouting has been suggested as the possible explanation for these events, we propose that interference with the inhibitory mechanism of the proximal stomach may be another possible explanation for the increasing ulcer recurrence rates after proximal gastric vagotomy. At present, this is only a hypothesis and is suggested only by indirect evidence. Direct testing of the hypothesis will require complete purification of the inhibitor and the development of a specific radioimmunoassay.
胃近端的黏膜含有一种强力的胃酸分泌及胃泌素释放抑制剂。这种抑制剂的释放依赖于胃近端完整的迷走神经支配。因此，近端胃迷走神经切断术会干扰该抑制剂的释放。在因消化性溃疡行近端胃迷走神经切断术后，溃疡复发率会随时间增加。此外，胃酸分泌会有一定程度的恢复。虽然神经再生或发芽被认为是这些现象的可能解释，但我们提出，对胃近端抑制机制的干扰可能是近端胃迷走神经切断术后溃疡复发率增加的另一种可能解释。目前，这只是一个假说，且仅有间接证据支持。对该假说进行直接验证需要完全纯化该抑制剂并开发特异性放射免疫测定法。
