Chen T S, Tsay S H, Chang F Y, Lee S D
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Am J Gastroenterol. 1994 Sep;89(9):1511-4.
To understand the short-term and long-term effects of the eradication of Helicobacter pylori on serum pepsinogen I, gastrin, and insulin concentration, we studied 53 patients with endoscopically proven duodenal ulceration and H. pylori infection.
All patients received a 2-wk course of colloidal bismuth subcitrate, amoxycillin, and metronidazole, and endoscopy was performed at 1.5, 3, 6, and 12 months after entry. H. pylori status was assessed by a urease test and histology.
Among 43 patients in whom H. pylori was eradicated throughout the follow-up year, the mean basal pepsinogen I was 108 ng/ml at pretreatment, decreasing significantly to 85, 77, 80, and 75 ng/ml at 1.5, 3, 6, and 12 months, respectively, at posttreatment. The basal gastrin was 100 pg/ml at pretreatment and fell significantly to 72, 64, 65, and 59 pg/ml, respectively, posttreatment. Of the four patients in whom the H. pylori was not eradicated, there was no significant change in the median basal pepsinogen I and gastrin concentration. Among the six patients in whom the H. pylori was again detectable within the follow-up year, the fallen serum concentration of pepsinogen I and gastrin returned to the pretreatment level. There was no significant change of basal insulin concentration after triple therapy in either the successfully eradicated or failed group.
We conclude that H. pylori is the leading and direct cause of higher serum concentration of pepsinogen I and gastrin in duodenal ulcer patients.
为了解根除幽门螺杆菌对血清胃蛋白酶原I、胃泌素和胰岛素浓度的短期及长期影响，我们研究了53例经内镜证实患有十二指肠溃疡且感染幽门螺杆菌的患者。
所有患者接受了为期2周的枸橼酸铋钾、阿莫西林和甲硝唑治疗疗程，并在入组后的1.5、3、6和12个月进行了内镜检查。通过尿素酶试验和组织学评估幽门螺杆菌状态。
在整个随访年中幽门螺杆菌被根除的43例患者中，治疗前基础胃蛋白酶原I的平均值为108 ng/ml，治疗后在1.5、3、6和12个月时分别显著降至85、77、80和75 ng/ml。治疗前基础胃泌素为100 pg/ml，治疗后分别显著降至72、64、65和59 pg/ml。在4例幽门螺杆菌未被根除的患者中，基础胃蛋白酶原I和胃泌素浓度的中位数无显著变化。在随访年内再次检测到幽门螺杆菌的6例患者中，胃蛋白酶原I和胃泌素下降的血清浓度恢复到治疗前水平。在成功根除或失败组中，三联疗法后基础胰岛素浓度均无显著变化。
我们得出结论，幽门螺杆菌是十二指肠溃疡患者血清胃蛋白酶原I和胃泌素浓度升高的主要直接原因。
