EFFECT OF HELICOBACTER PYLORI INFECTION ON GASTRIC AICD SECRETION

背景：幽门螺杆菌感染对胃酸分泌的影响尚不清楚。方法：对兰索拉唑和莫西林治疗前后胃溃疡（GU）和十二指肠溃疡（DU）患者的胃液pH、胃液氨氮浓度、血清胃泌素水平及胃炎分级（Sydney System）进行测定，并与幽门螺杆菌阴性对照进行比较。结果：与DU患者相比，GU患者，尤其是近端定位GU患者的幽门螺杆菌密度、萎缩、化生和胃炎活性评分更高。GU患者的胃液pH值明显高于DU患者和对照组。在根除幽门螺杆菌后，GU和DU患者的胃液pH和血清胃泌素水平均显著降低至对照水平。在未根除幽门螺杆菌的患者中，这些参数没有明显变化。结论：上述结果提示，幽门螺杆菌感染和胃炎可抑制胃酸分泌，使胃液pH升高，导致高胃泌素血症，根除幽门螺杆菌可使胃酸分泌和血清胃泌素水平恢复正常。

Background : How Helicobacter pylori infection affects gastric acid secretion is still unclear.Methods : Gastric juice pH and a mmonia concentrationing astric juice, serum gastrin level, and grade of gastritis according to the Sydney System were determined for patients with gastric ulcer (GU) and duodenal ulcer (DU) before and a ftertreatment with lansoprazole and a moxicillin, and results were compared with H.pylori-negative controls.Results : Scores for H.pylori-density, atrophy, metaplasia, and activity of gastritis in the corpus were higher in patients with GU,especially proximally those with located GU,than in those with DU.Gastric juice pH was significantly higher in GU patients than in DU patients and controls. After eradication of H.pylori, gastric juice pH and serum gastrin levels in both GU and DU patients were significantly decreased to control levels. In patients without eradication of H.pylori, no significant changes in those parameters were observed.Conclusions : These findings suggest that H.pylori infection and gastritis in the corpus suppress acid secretion and increase gastric juice pH,resulting in hypergastrinemia, and that eradiction of H.pylori normalizes acid secretion and serum gastrin levels.