Clémençon G, Bürgi W
Schweiz Med Wochenschr. 1977 Jul 9;107(27):952-6.
Samples of gastric contents from 152 patients with pyloric reflex were taken during gastroscopy after an overnight fast and examined for hemolytic activity. Hemolysis was induced by 97 specimens (64%). The hemolysis test was positive in 45% of patients with a histologically normal gastric mucosa, in 76% of patients suffering from chronic atrophic gastritis with intestinal metaplasia, in 83% with gastric erosions and in 67% with gastric ulcer. No lysolecithin was found in 9 of the 97 positive specimens. The other aspirates contained widely differing values up to 320 mg/100 ml. The average quantities of lysolecithin in gastric contents varied in the different patient groups from 20 to 60 mg/100 ml. These values are much higher than the mean value of 0.9 mg/100 ml quantified in patients without pyloric reflex during an earlier investigation. It is now widely accepted that pyloric reflex promotes gastritis. Furthermore, it has been shown on several occasions that bile constituents exert a damaging effect on the gastric mucosa barrier. The same is true of lysolecithin, which promotes (for example) acute cholecystitis under experimental conditions. These findings, together with the results of our investigation, seem to afford evidence that lysolecithins may exert a pathogenic influence in the development of different gastric lesions.
对152例有幽门反射的患者在禁食一夜后的胃镜检查期间采集胃内容物样本，并检测其溶血活性。97份样本（64%）可诱导溶血。在组织学上胃黏膜正常的患者中，溶血试验阳性率为45%；在患有慢性萎缩性胃炎伴肠化生的患者中为76%；有胃糜烂的患者中为83%；有胃溃疡的患者中为67%。97份阳性样本中有9份未检测到溶血卵磷脂。其他吸出物中的溶血卵磷脂含量差异很大，最高可达320mg/100ml。不同患者组胃内容物中溶血卵磷脂的平均含量在20至60mg/100ml之间。这些值远高于早期一项研究中无幽门反射患者所测定的0.9mg/100ml的平均值。现在人们普遍认为幽门反射会促进胃炎。此外，多次研究表明胆汁成分会对胃黏膜屏障产生损害作用。溶血卵磷脂也是如此，例如在实验条件下它会引发急性胆囊炎。这些发现以及我们的研究结果似乎都证明溶血卵磷脂可能在不同胃部病变的发展过程中发挥致病作用。
