Louw J A, Young G O, Lucke W, Bridger S, Winter T A, Marks I N
Gastrointestinal Clinic, University of Cape Town, South Africa.
Ital J Gastroenterol Hepatol. 1998 Aug;30(4):363-7.
The effect of infection by Helicobacter pylori on gastric physiology in duodenal ulcer subjects is controversial. There is evidence that the infection is associated with abnormalities in gastrin homeostasis. Consistent changes in pentagastrin-stimulated acid secretory status have proved difficult to establish. This may be because patients have been studied too soon after Helicobacter pylori eradication.
To study the immediate and longer term effect of Helicobacter pylori eradication on basal and pentagastrin-stimulated acid secretion in duodenal ulcer subjects.
Patients with active duodenal ulcer disease were studied. Ulcers were healed with sucralfate 2 g bd or ranitidine 300 mg nocte. Helicobacter pylori eradication was attempted with bismuth-based "Triple Therapy", and the nine patients in whom the organism was successfully eradicated were followed and studied over the 12-month period. Acid secretion was studied at entry (prior to the initiation of therapy), following healing, following eradication and 12 months later. Basal, low dose (0.1 microgram/kg) and high dose (6 micrograms/kg) pentagastrin-stimulated acid secretion was determined.
Whilst there was a tendency for basal and low dose-stimulated acid secretion to fall following eradication, in this study only the reduction in high dose-stimulated acid secretion achieved significance following eradication (entry mean = 59.6, post eradication mean = 49.6, p < 0.03). This effect of eradication on high dose pentagastrin-stimulated acid secretion was also seen at the 12-month study (mean = 48.9, p < 0.02 versus entry).
The findings of this study suggests that maximally stimulated acid secretion is modestly, albeit significantly, reduced following Helicobacter pylori eradication and that this effect persists.
幽门螺杆菌感染对十二指肠溃疡患者胃生理功能的影响存在争议。有证据表明，该感染与胃泌素稳态异常有关。五肽胃泌素刺激的胃酸分泌状态的一致性变化难以确定。这可能是因为在幽门螺杆菌根除后不久就对患者进行了研究。
研究幽门螺杆菌根除对十二指肠溃疡患者基础胃酸分泌和五肽胃泌素刺激的胃酸分泌的近期及长期影响。
对患有活动性十二指肠溃疡疾病的患者进行研究。溃疡用2克/每日两次的硫糖铝或300毫克/每晚的雷尼替丁治愈。尝试用铋剂“三联疗法”根除幽门螺杆菌，对9例成功根除该菌的患者进行为期12个月的随访和研究。在入组时（治疗开始前）、愈合后、根除后及12个月后研究胃酸分泌情况。测定基础胃酸分泌、低剂量（0.1微克/千克）和高剂量（6微克/千克）五肽胃泌素刺激的胃酸分泌。
虽然根除后基础胃酸分泌和低剂量刺激的胃酸分泌有下降趋势，但在本研究中，只有根除后高剂量刺激的胃酸分泌的减少具有统计学意义（入组时平均值 = 59.6，根除后平均值 = 49.6，p < 0.03）。在12个月的研究中也观察到根除对高剂量五肽胃泌素刺激的胃酸分泌的这种影响（平均值 = 48.9，与入组时相比p < 0.02）。
本研究结果表明，幽门螺杆菌根除后，最大刺激胃酸分泌虽有显著但适度的降低，且这种影响持续存在。
