Iijima K, Ohara S, Sekine H, Koike T, Kubota Y, Kato K, Asaki S, Toyota T
The 3rd Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Am J Gastroenterol. 1998 Nov;93(11):2113-8. doi: 10.1111/j.1572-0241.1998.00603.x.
To date, the effect of Helicobacter pylori on acid secretion remains controversial. To evaluate changes in the gastric acid secretory response before and after H. pylori eradication in a large number of patients, we devised a new endoscopic method of gastric acid secretory testing, the endoscopic gastrin test (EGT).
In EGT, endoscopy was begun 15 min after intramuscular injection of 4 microg/kg tetragastrin. Gastric fluid secreted between 20 and 30 min after gastrin injection was aspirated and collected during endoscopic examination. The amount of acid in the sample collected over this 10-min period was estimated by titration and expressed in H+ mEq/10 min. Fifteen subjects underwent a conventional secretory test using a nasogastric tube (conventional method) and EGT on different days to assess the correlation between results obtained with the two methods. In 10 of these subjects, EGT was repeated under the same conditions to assess its reproducibility.
EGT values correlated very well with peak acid output determined by the conventional method (n = 15, r = 0.92) and had high reproducibility (n = 10, CV = 5.6). We noted that EGT takes just a little longer to perform than a routine endoscopic examination, and the influence of an endoscope in the stomach on acid secretion was not present.
The EGT should be very useful as a rapid, simple substitute for conventional secretory testing when repeated gastric secretory tests are required, especially in investigating the effect of H. pylori on acid secretion in a larger population.
迄今为止，幽门螺杆菌对胃酸分泌的影响仍存在争议。为了评估大量患者根除幽门螺杆菌前后胃酸分泌反应的变化，我们设计了一种新的内镜下胃酸分泌检测方法，即内镜胃泌素试验（EGT）。
在EGT中，肌肉注射4μg/kg的四肽胃泌素15分钟后开始进行内镜检查。在内镜检查期间，抽取并收集胃泌素注射后20至30分钟内分泌的胃液。通过滴定法估算在这10分钟内收集的样本中的酸量，并以H⁺ mEq/10分钟表示。15名受试者在不同日期分别接受了使用鼻胃管的传统分泌试验（传统方法）和EGT，以评估两种方法所得结果之间的相关性。在其中10名受试者中，在相同条件下重复进行EGT以评估其可重复性。
EGT值与传统方法测定的最大酸排量相关性非常好（n = 15，r = 0.92），并且具有高可重复性（n = 10，CV = 5.6）。我们注意到EGT的操作时间仅比常规内镜检查稍长一点，并且胃内的内镜对胃酸分泌没有影响。
当需要重复进行胃分泌试验时，尤其是在研究幽门螺杆菌对更多人群胃酸分泌的影响时，EGT作为一种快速、简单的传统分泌试验替代方法应该非常有用。
