Knoll M R, Kölbel C B, Teyssen S, Singer M V
Dept. of Medicine IV (Gastroenterology), University Hospital of Heidelberg at Mannheim, Germany.
Endoscopy. 1998 Mar;30(3):293-301. doi: 10.1055/s-2007-1001257.
The action of ethanol and alcoholic beverages on the gastric mucosa in healthy humans is largely unknown. This study was designed to compare the effects of beer, white wine, whisky, and the comparable pure ethanol solutions on the gastric and duodenal mucosa in a controlled, randomized, double-blind endoscopic investigation.
In 47 healthy human volunteers, 100 ml of beer, or white wine, or whisky, or a comparable pure ethanol solution (4%, 10%, 40% vol/vol), or isotonic saline as a control, were sprayed on the antral mucosa. The endoscopic appearance of the gastric and duodenal mucosa was assessed before, immediately after, and 30, 60, 240 minutes and 24 hours after instillation. The lesions were scored using an endoscopic grading system (0-5; 0 = normal mucosa and 5 = ten or more hemorrhagic lesions).
Pure ethanol damaged the gastric mucosa in a dose-dependent fashion. The lesions occurred within 30 minutes, and reached a maximum after 60 minutes (antral score for 4% = 1.3; 10% = 1.8; 40% 3.8; control = 1.5). Beer, wine and whisky also induced gastric mucosal injury, but to a lesser extent than the comparable ethanol solutions. The 24-hour integrated endoscopic scores for beer and wine were significantly lower (P < 0.05) than the corresponding ethanol content. In the case of pure ethanol > 10% and whisky, the lesions were still present 24 hours later (antral score for 10% = 1.5; 40% = 2.0; whisky = 2.3; control = 0). No lesions were observed in the duodenum. None of the volunteers reported any abdominal pain during the whole investigation.
Intragastric application of 4%, 10%, and 40% vol/vol pure ethanol induces gastric, but not duodenal, mucosal lesions in a dose-dependent fashion. Beer, white wine, and whisky induce gastric mucosal lesions to a lesser degree than the corresponding ethanol content. Lesions induced by higher ethanol concentrations (> 10%) and whisky take more than 24 hours to heal. The lesser damage caused by alcoholic beverages may be due to the protective action of unknown nonalcoholic ingredients.
乙醇及酒精饮料对健康人胃黏膜的作用在很大程度上尚不清楚。本研究旨在通过一项对照、随机、双盲的内镜检查，比较啤酒、白葡萄酒、威士忌以及相应的纯乙醇溶液对胃和十二指肠黏膜的影响。
在47名健康志愿者中，将100毫升啤酒、白葡萄酒、威士忌、相应的纯乙醇溶液（4%、10%、40%体积/体积）或作为对照的等渗盐水喷洒在胃窦黏膜上。在滴注前、滴注后即刻、30分钟、60分钟、240分钟和24小时对胃和十二指肠黏膜的内镜表现进行评估。使用内镜分级系统（0 - 5级；0 = 正常黏膜，5 = 十个或更多出血性病变）对病变进行评分。
纯乙醇以剂量依赖方式损伤胃黏膜。病变在30分钟内出现，60分钟后达到最大值（4%乙醇的胃窦评分为1.3；10%乙醇为1.8；40%乙醇为3.8；对照为1.5）。啤酒、葡萄酒和威士忌也会引起胃黏膜损伤，但程度低于相应的乙醇溶液。啤酒和葡萄酒的24小时综合内镜评分显著低于（P < 0.05）相应的乙醇含量。对于大于10%的纯乙醇和威士忌，24小时后仍有病变（10%乙醇的胃窦评分为1.5；40%乙醇为2.0；威士忌为2.3；对照为0）。十二指肠未观察到病变。在整个研究过程中，没有志愿者报告任何腹痛。
胃内应用4%、10%和40%体积/体积的纯乙醇会以剂量依赖方式引起胃黏膜损伤，但不会引起十二指肠黏膜损伤。啤酒、白葡萄酒和威士忌引起的胃黏膜损伤程度低于相应的乙醇含量。较高乙醇浓度（> 10%）和威士忌引起的病变需要超过24小时才能愈合。酒精饮料造成的损伤较小可能归因于未知非酒精成分的保护作用。
