幽门螺旋杆菌感染对胃液pH的影响

Effect of Helicobacter pylori infection on gastric juice pH

摘要:

目的探讨幽门螺旋杆菌感染如何影响胃酸的分泌.方法选择近端胃溃疡患者40例,远端胃溃疡80例,球部溃疡104例.所有患者均经胃镜检查证实,并经快速酶法和病理组织学证实幽门螺杆菌阳性.对近端和远端胃溃疡患者给予奥美拉唑胶囊0.02每日1次口服共6周,球部溃疡共4周,在此基础上,所有患者第1周加阿莫西林1.0和甲硝唑0.4每日2次口服,分别在治疗前、治疗后、治疗后1个月进行胃镜检查并测定胃液pH、氨浓度、血清胃泌素和胃炎积分,并与幽门螺杆菌阴性的40名正常人对照.结果胃液pH和血清胃泌素在胃溃疡(特别是近端胃溃疡)者较球部溃疡和对照组明显升高,幽门螺杆菌根治疗法后,胃溃疡和球部溃疡患者在根除者胃液pH和血清胃泌素水平降至对照组,未根治者这些因素无明显变化.结论本研究提示幽门螺杆菌感染抑制胃酸分泌,提高胃液pH引起高胃泌素血症,而根治幽门螺杆菌使胃酸分泌和血清胃泌素水平正常化.

Abstract:

Objective: To investigate how Helicobacter pylori infection affects gastric acid secretion. Methods: The subjects were 40 patients with proximally located gastric ulcer 80 patients with distally located gastric ulcer and 104 patients with duodenal ulcer (DU). These patients has proved by endoscopy and the all were H. Pylori postive on the basis of rapid urease test and histologic examination. For ulcer treatment, 0.02 omeprazole (Losec) was administered once daily for 6 weeks to patients with proximal and distal gastric ulcer, for 4 weeks to patients with DU. In addition, 1.0 amoxicilin and 0.4 metronidazolum two times daily was administered for the first week on the above treatment. The pH and ammonia Concentration in Gastric juice, serum gastrin and grade of gastritis scores were determined before treatment, at the end of treatment and 1 month after treatment results were compared with those of H. pylori-negative controls. Results: Gastric juice pH and serum gastrin level were higher in patients with GU than pathents of DU and controls. After H. pylori eratication treatment, in patients with eradication, gastic juice pH and serum gastrin levels in both GU and DU patients were significantly decreased to controls levels. In patients without eradication, no significant changes were observed. Conclusions: These findings suggest that H. pylori infection suppres acid secretion and increase gastric juice pH resulting in hypergastrinemia, the eradication of H.pylori make normalizes of acid secretion and serum gastrin levels.