Koop H, Frank M, Kuly S, Nold R, Eissele R, Rager G, Rüschoff J, Rothmund M, Arnold R
Department of Medicine, Philipps-University, Marburg, Germany.
Dig Dis Sci. 1993 Feb;38(2):295-302. doi: 10.1007/BF01307547.
The number, size, and volume density of endocrine cells was determined in biopsies obtained endoscopically in patients after proximal selective vagotomy (PSV; N = 31), antrectomy (N = 9), untreated duodenal ulcer (DU) disease (N = 11), and in controls (N = 15). Serum gastrin was significantly elevated after PSV (mean 60 pg/ml) compared to DU patients (29 pg/ml), controls (26 pg/ml), and after antrectomy (11 pg/ml). Volume density of fundic argyrophil (largely enterochromaffin-like) cells after PSV (0.74%) and in DU disease (0.63%) were significantly (P < 0.001) higher when compared with controls (0.37%) but lower after antrectomy (0.24%; P < 0.02). The density of argyrophil cells was not influenced by the interval following PSV or the magnitude of hypergastrinemia. Antral gastrin cells were increased after vagotomy, whereas the antral and fundic somatostatin cell numbers were reduced after PSV. It is concluded that: (1) a major role of the vagal nerve as a trophic factor for enterochromaffin-like cells could not be demonstrated after PSV, and (2) moderate hypergastrinemia after PSV did not induce proliferation of ECL cells.
对近端选择性迷走神经切断术(PSV;N = 31)、胃窦切除术(N = 9)、未经治疗的十二指肠溃疡(DU)疾病(N = 11)患者以及对照组(N = 15)在内镜检查时获取的活检组织中内分泌细胞的数量、大小和体积密度进行了测定。与DU患者(29 pg/ml)、对照组(26 pg/ml)以及胃窦切除术后(11 pg/ml)相比,PSV后血清胃泌素显著升高(平均60 pg/ml)。PSV后(0.74%)和DU疾病患者中(0.63%)胃底嗜银(主要是肠嗜铬样)细胞的体积密度与对照组(0.37%)相比显著更高(P < 0.001),但胃窦切除术后更低(0.24%;P < 0.02)。嗜银细胞的密度不受PSV后时间间隔或高胃泌素血症程度的影响。迷走神经切断术后胃窦胃泌素细胞增加,而PSV后胃窦和胃底生长抑素细胞数量减少。得出以下结论:(1)PSV后无法证明迷走神经作为肠嗜铬样细胞营养因子的主要作用,(2)PSV后中度高胃泌素血症未诱导肠嗜铬样细胞增殖。