DUODENOGASTRIC REFLUX IN HEALTH AND DISEASE

十二指肠胃反流与健康和疾病的关系

• 批准号: 3240601
• 负责人: RONALD A HINDER
• 金额: $ 23.31万
• 依托单位: CREIGHTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-08-15 至 1992-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3240601
• 关键词: acid base balance; dogs; duodenum disorder; electrodes; excretion; gastric acid; gastric mucosa; gastrointestinal disorder diagnosis; human subject; radionuclide imaging /scanning; stomach disorder; stomach emptying; stomach surgery

Duodenogastric reflux (DGR) is a poorly defined condition which is difficult to accurately diagnose. There is a definite need for a simple test which can be used to define both the existence and severity of the disease. The long term monitoring of gastric intraluminal pH holds promise in this respect. The first aim is to measure the gastric luminal pH at different levels between the cardia and the pylorus in normal human volunteers and dogs to determine how the pH varies in different parts of the stomach under normal physiological conditions. The pH environment is probably influenced by eating, changes in posture, DGR, gastric emptying and acid secretion, therefore the intraluminal pH environment will be mapped at different sites in the stomach over prolonged periods of different physiologic activity including eating, posture change, induced DGR and altered gastric motility and acid secretion. With this background information, computer assisted analysis of gastric pH data in symptomatic patients will help define whether the disease of pathologic DGR indeed exists and a comparison with existing tests will indicate whether prolonged intragastric pH measurements on their own can be used in diagnosing the condition. Surgical therapy of DGR has included the use of the Roux-en-Y operation which results in profound alterations in gastrointestinal function. We have recently developed an alternative operation (the "duodenal switch") which appears to be more physiologic in that no vagotomy is required and the antro-pyloric mechanism is left intact. These two surgical procedures will be analyzed and compared in both animals and humans. A key feature of the "duodenal switch" involves suppression of acid secretion by a duodenal feedback mechanism. This will be studied using Pavlov pouches in dogs. The results of this project will provide a better understanding of the phenomenon of DGR, more definitive diagnosis of pathologic DGR, and will explore the physiological advantages of a new surgical therapy.

十二指肠胃反流（DGR）是一种定义不清的疾病， 很难准确诊断。有一个简单的明确的需要 测试，可用于定义的存在和严重性 疾病胃腔内pH值的长期监测是有希望的 在这方面。第一个目的是测量胃腔pH值， 正常人贲门与幽门之间的不同水平 志愿者和狗，以确定如何pH值的不同部分， 正常生理条件下的胃。所述pH环境是 可能受进食、姿势变化、DGR、胃排空影响 和酸分泌，因此管腔内的pH环境将是 在胃的不同部位， 不同的生理活动，包括进食，姿势改变，诱导 DGR和胃动力和酸分泌改变。在这样的背景下 信息，计算机辅助分析胃pH值数据的症状 患者将有助于确定病理性DGR疾病是否确实 存在，与现有测试的比较将表明是否延长 胃内pH值测量本身可用于诊断 条件 DGR的外科治疗包括Roux-en-Y手术的使用 这导致胃肠道功能的深刻改变。我们有 最近开发了一种替代手术（“十二指肠开关”）， 似乎更符合生理学，因为不需要迷走神经切断术， 胃窦幽门机制完好无损这两种手术方法将 在动物和人类身上进行分析和比较。的关键特征 “十二指肠转换”涉及通过十二指肠切除术抑制酸分泌。 反馈机制这将在犬中使用巴甫洛夫袋进行研究。 该项目的结果将使人们更好地了解 DGR现象，更明确的诊断病理DGR，并将 探索一种新的外科治疗的生理优势。