Waldum H L, Brenna E, Kleveland P M, Sandvik A K, Syversen U
Department of Medicine, University Hospital, Trondheim, Norway.
Aliment Pharmacol Ther. 1993 Dec;7(6):589-96. doi: 10.1111/j.1365-2036.1993.tb00139.x.
All vertebrates secrete gastric acid. Acid denatures the proteins in the food and thus makes them more accessible to proteolytic enzymes, and it kills swallowed micro-organisms. Gastric acid plays an important pathogenetic role in peptic ulcer disease and reflux oesophagitis. In these diseases, drugs that inhibit secretion of gastric acid will heal the lesions and suppress the symptoms. However, both reflux oesophagitis and peptic ulcer tend to recur when the acid-inhibitory treatment is stopped. Therefore, these patients often require long-term treatment with acid-inhibitors. In this overview the potential risks of long-term profound inhibition of acid secretion, raising the pH above 4 for a considerable time, resulting in reduced killing of micro-organisms and secondary hypergastrinaemia, are discussed. Gastrin regulates both the function (production and release of histamine) and growth of the enterochromaffin-like (ECL) cell. Hitherto, the role that this cell plays in gastric carcinogenesis appears to have been underestimated.
所有脊椎动物都会分泌胃酸。胃酸会使食物中的蛋白质变性，从而使蛋白水解酶更容易作用于这些蛋白质，并且胃酸还能杀死被咽下的微生物。胃酸在消化性溃疡病和反流性食管炎的发病机制中起着重要作用。在这些疾病中，抑制胃酸分泌的药物能够治愈病变并缓解症状。然而，当停止抑酸治疗时，反流性食管炎和消化性溃疡往往会复发。因此，这些患者通常需要长期使用抑酸剂进行治疗。在本综述中，将讨论长期深度抑制胃酸分泌，使pH值在相当长的时间内高于4，导致微生物杀灭减少和继发性高胃泌素血症的潜在风险。胃泌素调节肠嗜铬样（ECL）细胞的功能（组胺的产生和释放）以及生长。迄今为止，这种细胞在胃癌发生中所起的作用似乎一直被低估。
