Banerjee S, Hawksby C, Miller S, Dahill S, Beattie A D, McColl K E
Gastrointestinal Centre, Southern General Hospital, Glasgow.
Gut. 1994 Mar;35(3):317-22. doi: 10.1136/gut.35.3.317.
The presence of ascorbic acid in gastric juice may protect against gastric carcinoma and peptic ulceration. This study examined the effect of Helicobacter pylori (H pylori) on the secretion of ascorbic acid into gastric juice by measuring fasting plasma and gastric juice ascorbic acid concentrations in patients with and without the infection and also before and after its eradication. Gastric juice ascorbic acid concentrations in 19 H pylori positive patients were significantly lower (median 2.8, range 0-28.8 micrograms/ml) than those in 10 H pylori negative controls (median 17.8, range 5.6-155.4 micrograms/ml) (p < 0.0005) despite similar plasma ascorbic acid concentrations in both groups. The median gastric juice:plasma ascorbic acid ratio in the H pylori positive patients was only 1.16 (range 0.02-6.67), compared with a median ratio of 4.87 (range 0.76-21.33) in H pylori negative controls (p < 0.01). In the patients with H pylori infection there was a significant negative correlation between the severity of the antral polymorphonuclear infiltrate and gastric juice ascorbic acid concentrations (correlation coefficient -0.52, p = 0.02). After eradication of H pylori in 11 patients, gastric juice ascorbic acid concentrations rose from 2.4 (0-12.8 micrograms/ml) to 11.2 (0-50 micrograms/ml) (p = 0.01). The median gastric juice: plasma ascorbic acid ratio also increased from 1.33 (0.05-6.67) to 2.89 (0.01-166) (p = 0.01). In conclusion, the high gastric juice:plasma ascorbic acid ratio in H pylori negative subjects shows active secretion of ascorbic acid into gastric juice. Secondly, H pylori infection causes a reversible lowering of gastric juice ascorbic acid concentrations, which may predispose to gastric carcinoma and peptic ulceration.
胃液中抗坏血酸的存在可能预防胃癌和消化性溃疡。本研究通过测量有无幽门螺杆菌（H pylori）感染患者的空腹血浆和胃液中抗坏血酸浓度，以及在根除幽门螺杆菌前后的浓度，来研究幽门螺杆菌对胃液中抗坏血酸分泌的影响。19例幽门螺杆菌阳性患者的胃液抗坏血酸浓度（中位数2.8，范围0 - 28.8微克/毫升）显著低于10例幽门螺杆菌阴性对照者（中位数17.8，范围5.6 - 155.4微克/毫升）（p < 0.0005），尽管两组的血浆抗坏血酸浓度相似。幽门螺杆菌阳性患者胃液与血浆抗坏血酸浓度的中位数比值仅为1.16（范围0.02 - 6.67），而幽门螺杆菌阴性对照者的中位数比值为4.87（范围0.76 - 21.33）（p < 0.01）。在幽门螺杆菌感染患者中，胃窦多形核白细胞浸润的严重程度与胃液抗坏血酸浓度之间存在显著负相关（相关系数 -0.52，p = 0.02）。11例患者根除幽门螺杆菌后，胃液抗坏血酸浓度从2.4（0 - 12.8微克/毫升）升至11.2（0 - 50微克/毫升）（p = 0.01）。胃液与血浆抗坏血酸浓度的中位数比值也从1.33（0.05 - 6.67）增至2.89（0.01 - 166）（p = 0.01）。总之，幽门螺杆菌阴性受试者胃液与血浆抗坏血酸浓度的高比值表明抗坏血酸向胃液中有活跃分泌。其次，幽门螺杆菌感染导致胃液抗坏血酸浓度可逆性降低，这可能易引发胃癌和消化性溃疡。
