Moss S F, Calam J
Gastroenterology Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Gut. 1993 Jul;34(7):888-92. doi: 10.1136/gut.34.7.888.
The effect of ulcer healing with eradication of Helicobacter pylori (H pylori) on gastric function was investigated in nine patients with duodenal ulcer disease. One month after eradication there were significant reductions in both basal plasma gastrin concentration, from a median (range) of 19 (1-22) to 6 (2-15) pmol/l (p < 0.05), and of basal acid secretion from 8.3 (2.4-24) to 2.6 (1.4-8.1) mM H+/h, (p < 0.01). The peak acid secretion rate was unchanged from 37 (16-59) to 37 (21-59) mM H+/h. After treatment there was no change in the parietal cell sensitivity to stepped infusions of gastrin heptadecapeptide: the median concentration of gastrin required for 50% of maximal acid secretion (EC50) was 41 (14.8-126) before and 33 (23-125) pmol/l after eradication of H pylori. The metabolic clearance rate of gastrin was also unaffected by the eradication of H pylori. Thus eradication of H pylori infection from patients with active duodenal ulcers is accompanied by falls in both basal gastrin release and basal acid secretion without a change in the parietal cell sensitivity to gastrin. Cyclical changes in H pylori infection may cause the variations in basal acid secretion that are seen in duodenal ulcer disease.
对9例十二指肠溃疡患者研究了根除幽门螺杆菌（H pylori）促进溃疡愈合对胃功能的影响。根除幽门螺杆菌1个月后，基础血浆胃泌素浓度显著降低，从中位数（范围）19（1 - 22）降至6（2 - 15）pmol/l（p < 0.05），基础胃酸分泌从8.3（2.4 - 24）降至2.6（1.4 - 8.1）mM H⁺/h（p < 0.01）。胃酸分泌峰值速率未变，从37（16 - 59）降至37（21 - 59）mM H⁺/h。治疗后壁细胞对十七肽胃泌素阶梯式输注的敏感性未改变：根除幽门螺杆菌前，最大胃酸分泌量的50%所需胃泌素的中位数浓度（EC50）为41（14.8 - 126）pmol/l，根除后为33（23 - 125）pmol/l。胃泌素的代谢清除率也不受根除幽门螺杆菌的影响。因此，根除活动性十二指肠溃疡患者的幽门螺杆菌感染会伴随基础胃泌素释放和基础胃酸分泌下降，而壁细胞对胃泌素的敏感性不变。幽门螺杆菌感染的周期性变化可能导致十二指肠溃疡疾病中所见的基础胃酸分泌变化。
