Himal H S, Werther J L, Chapman M L, Janowitz H D, Rudick J
Ann Surg. 1977 Apr;185(4):481-7. doi: 10.1097/00000658-197704000-00019.
Alterations in composition of isosmotic acid solutions were studied in exteriorized segments of the proximal (Brunner's gland area) and distal canine duodenum, mounted in lucite chambers. Varying concentrations of HCl (40, 80, 120, 160 mEq/l) made isotonic by the addition of NaCl were instilled into the chamber, removed in 15 minutes and analyzed for volume, electrolytes, protein content and osmolality. Both proximal and distal duodenal mucosa modified the instilled solution with a loss of H+ and a gain in Na+ and K+, which occurred at similar rates independent of the acid concentration of the instilled solution. The rate of ionic movement was twice that for the antrum, and 30-100 times that of the fundus. Calculated H+ loss across the entire duodenal mucosa at these rates could account for 17.5% of the peak acid output from the canine stomach. The loss of H+ could not be accounted for on the basis of neutralization and probably represented transmucosal insorption. In addition to the neutralization of gastric acid by pancreatic juice and bile, duodenal mucosa thus plays an important role in the maintenance of intraluminal pH. Duodenal mucosal permeability to H+ may be related to the vulnerability of the duodenal mucosa to acid-peptic ulceration.
在安装于透明塑料小室中的犬近端（布伦纳腺区）和远端十二指肠的外置节段中，研究了等渗酸溶液成分的变化。将通过添加氯化钠使其等渗的不同浓度的盐酸（40、80、120、160毫当量/升）滴入小室，15分钟后取出，并分析其体积、电解质、蛋白质含量和渗透压。近端和远端十二指肠黏膜均对滴入的溶液进行了修饰，氢离子丢失，钠离子和钾离子增加，且发生速率相似，与滴入溶液的酸浓度无关。离子移动速率是胃窦的两倍，是胃底的30 - 100倍。以这些速率计算，整个十二指肠黏膜的氢离子丢失量可占犬胃最大酸排量的17.5%。氢离子的丢失无法用中和作用来解释，可能代表经黏膜吸收。除了胰液和胆汁对胃酸的中和作用外，十二指肠黏膜在维持管腔内pH值方面也起着重要作用。十二指肠黏膜对氢离子的通透性可能与十二指肠黏膜对酸-消化性溃疡的易感性有关。
