Brown C M, Snowdon C F, Slee B, Sandle L N, Rees W D
Department of Gastroenterology, Hope Hospital, University of Manchester, School of Medicine, Salford.
Gut. 1995 May;36(5):649-53. doi: 10.1136/gut.36.5.649.
Recent human studies suggest that oesophageal HCO3- secretion, in conjunction with salivary HCO3- secretion and secondary oesophageal peristalsis, is important for the protection of oesophageal mucosa from refluxed gastric contents. This study evaluated simultaneously the responsiveness of oesophageal and salivary HCO3- secretion to oesophageal acidification in eight healthy subjects. A 10 cm segment of oesophagus was perfused at a constant rate of 5 ml/min with a specially designed tube assembly. Saline was used initially, and then 10 mM and 100 mM HCl. The perfusates contained 3H-polyethylene glycol (PEG) as a concentration marker to determine volumes. Corrections were applied for a small degree of contamination by swallowed saliva and refluxed gastric alkali. Oesophageal perfusion with 10 mM HCl did not cause symptoms (nausea and heartburn), but tripled the oesophageal HCO3- output from a baseline of 51 mumol/10 cm/10 min (p = 0.021), while doubling the rate of salivary HCO3- secretion from a median basal value of 140 mumol/10 min (p = 0.021). Oesophageal perfusion with 100 mM HCl was associated with symptoms of nausea and heartburn in all subjects. The median oesophageal HCO3- output increased 32 fold to 1659 mumol/10 cm/10 min (interquartile range 569 to 3373; p = 0.036), and salivary HCO3- secretion approximately tripled from basal values (p = 0.036). In conclusion, oesophageal acidification stimulates both salivary and oesophageal HCO3- secretion, responses which may be protective to the oesophageal epithelium.
近期的人体研究表明，食管HCO₃⁻分泌与唾液HCO₃⁻分泌以及食管继发性蠕动共同作用，对于保护食管黏膜免受反流的胃内容物侵蚀至关重要。本研究同时评估了8名健康受试者食管和唾液HCO₃⁻分泌对食管酸化的反应性。使用特制的导管装置以5 ml/min的恒定速率对10 cm长的食管段进行灌注。最初灌注生理盐水，然后分别灌注10 mM和100 mM的盐酸。灌注液中含有³H-聚乙二醇（PEG）作为浓度标记物以测定容积。对吞咽唾液和反流胃碱造成的少量污染进行了校正。用10 mM盐酸进行食管灌注未引起症状（恶心和烧心），但食管HCO₃⁻输出量从基线的51 μmol/10 cm/10 min增加了两倍（p = 0.021），而唾液HCO₃⁻分泌速率从基础值中位数140 μmol/10 min增加了一倍（p = 0.021）。用100 mM盐酸进行食管灌注时，所有受试者均出现恶心和烧心症状。食管HCO₃⁻输出量中位数增加了32倍，达到1659 μmol/10 cm/10 min（四分位间距为569至3373；p = 0.036），唾液HCO₃⁻分泌量较基础值增加了约两倍（p = 0.036）。总之，食管酸化刺激唾液和食管HCO₃⁻分泌，这些反应可能对食管上皮具有保护作用。
