Feldman M, Walsh J H, Taylor I L
Gastroenterology. 1980 Aug;79(2):294-8.
To evaluate the role of endogenous opiates on gastric acid secretion, we infused naloxone, a pure opiate antagonist drug, into 8 healthy subjects in the basal state and then after an amino acid meal. Naloxone significantly reduced basal acid secretion and the gastric acid secretory response to the meal. Maximum inhibition averaged 65% for basal acid secretion and 35% for meal-stimulated secretion. Naloxone had no effect on serum gastrin concentraitons or on the rate of gastric emptying of the meal. In the same subjects morphine also significantly reduced meal-stimulated acid secretion. In contrast to naloxone, morphine delayed gastric emptying and also enhanced the gastrin response to the meal. Morphine also abolished the pancreatic polypeptide response to the meal. Our studies with naloxone suggest that endogenous opiates may augment gastric acid secretion in humans. Failure of exogenous opitates to increase acid secretion suggests that actions other than opiate receptor stimulation (such as anticholinergic effects) may have come into play during morphine infusion.
为评估内源性阿片类物质对胃酸分泌的作用,我们在基础状态下以及进食氨基酸餐后,给8名健康受试者输注了纯阿片拮抗剂药物纳洛酮。纳洛酮显著降低了基础胃酸分泌以及对进食的胃酸分泌反应。基础胃酸分泌的最大抑制平均为65%,进食刺激分泌的最大抑制平均为35%。纳洛酮对血清胃泌素浓度或进食后胃排空速率没有影响。在同一受试者中,吗啡也显著降低了进食刺激的胃酸分泌。与纳洛酮不同的是,吗啡延迟了胃排空,还增强了对进食的胃泌素反应。吗啡还消除了对进食的胰多肽反应。我们用纳洛酮进行的研究表明,内源性阿片类物质可能会增强人类的胃酸分泌。外源性阿片类物质未能增加胃酸分泌,这表明在输注吗啡期间,除了阿片受体刺激之外的其他作用(如抗胆碱能作用)可能发挥了作用。