Hp相关性胃窦炎对十二指肠溃疡患者血清胃泌素浓度的影响

目的探讨幽门螺杆菌相关性胃窦炎对十二指肠溃疡（ＤＵ）血清试餐胃泌素（ＭＳＧ）浓度的影响。方法对１００例ＤＵ患者进行内镜、胃粘膜组织学、幽门螺杆菌（Ｈｐ）和血清ＭＳＧ检查,并分析其相互关系。结果ＤＵ患者血清ＭＳＧ浓度（１２９．９±８７．２ｐｇ／ｍｌ）较对照组（８６．１±５１．２ｐｇ／ｍｌ）显著升高（Ｐ＜０．０１）,但其升高水平在伴发的不同胃窦炎中有显著差异（Ｐ＜０．０１）,即胃窦炎越重,血清ＭＳＧ越高。胃窦炎的轻重与Ｈｐ感染有关,ＤＵ患者中Ｈｐ感染率高（７５．０％）,与Ｈｐ相关的胃窦炎较重,其血清ＭＳＧ升高也较明显（１３７．０±１０７．５ｐｇ／ｍｌ）,但在Ｈｐ阴性的胃窦炎中,血清ＭＳＧ也随炎症的加重而升高。结论ＤＵ患者血清ＭＳＧ浓度升高可能受伴发胃窦炎的影响,Ｈｐ感染引起血清ＭＳＧ升高,可能也是通过促发或加重胃窦炎所致。     

金龙汤治疗非溃疡性消化不良的临床研究

目的：观察金龙汤对胃排空功能延迟型非溃疡性消化不良（ＮＵＤ）患者的治疗效果。方法：筛选胃排空功能延迟型ＮＵＤ患者３４例,随机分两组,分别予金龙汤和吗丁啉治疗,１２ 例健康人作为正常对照组,Ｂ超法检测服药前后胃液体排空功能变化,同时观察症状及血胃泌素、胃动素水平变化。结果：金龙汤组服药前后胃液体半排空时间明显缩短（Ｐ＜ ０．０１）;症状改善显效率优于吗丁啉组（Ｐ＜ ０．０５）;金龙汤组服药后血浆胃动素水平较服药前升高（Ｐ＜ ０．０５）,血清胃泌素水平变化不明显（ Ｐ＞ ０．０５）。结论：中药金龙汤是治疗胃排空功能延迟型ＮＵＤ的有效方剂。     

肝硬化患者血浆及胃粘膜内血管活性肠肽和生长抑素含量的变化及意义

本文采用放射免疫测定法研究了肝硬化（ＨＣ）患者血浆及胃粘膜内血管活性肠肽（ＶＩＰ）和生长抑素（ＳＳ）含量变化及其意义。结果表明：肝硬化患者血浆和胃粘膜内的ＶＩＰ含量（１７４·９９±８８·１１ｐｇ／ｍｌ，１０９．４７±３０．７０ｐｇ／ｍｇ）和ＳＳ含量（５０．８８±１５．８ｐｇ／ｍｌ，３９８．２１±１２５．７３ｐｇ／ｍｇ）均显著高于正常对照组（ＶＩＰ：１０７．４６±９．８ｐｇ／ｍｌ，５８．７４±６．７１ｐｇ／ｍｇ和ＳＳ：２６．８３±５．９２ｐｇ／ｍｌ，２１２．６２±４７．６４ｐｇ／ｍｇ）（Ｐ＜０．０１）。ＨＣ伴溃疡病患者血浆及粘膜中ＳＳ含量显著高于无溃疡的ＨＣ患者（Ｐ＜０．０５）；血浆及胃粘膜中ＶＩＰ的含量与胃、十二指肠粘膜充血程度呈正相关（Ｐ＜０．０５）；重度食管静脉曲张患者ＶＩＰ含量显著高于无食管静脉曲张者（Ｐ＜０．０５）；血浆及胃粘膜内ＶＩＰ和ＳＳ含量与血浆白蛋白呈负相关（Ｐ＜０．０１）和凝血酶原时间延长呈正相关（Ｐ＜０．０１）与腹水的有无及程度关系不密切。提示：在ＨＣ时存在着严重的胃肠激素代谢紊乱，并且它在ＨＣ的病理生理机制和ＨＣ时胃肠功能改变和病理变化中起着重要作用。     

西沙必利对功能性消化不良患者胃动力、胃动素、胃泌素影响的研究

对３０例功能性消化不良（ＦＤ）患者服用西沙必利前后的胃腔内压力、血中胃动素及胃泌素的变化进行检测，并以１１例正常人作对照。结果：①ＦＤ患者胃窦和胃体基础压、胃窦蠕动压及血中胃动素浓度，明显低于正常对照组（Ｐ值分别＜００５，＜００１）；而胃窦蠕动波持续时间、血中胃泌素浓度与正常组无显著差异（Ｐ＞００５）。②服用西沙必利后，ＦＤ患者与正常对照组胃窦和胃体基础压、胃窦蠕动压及血中胃动素浓度，均较服药前明显升高（Ｐ＜００５，Ｐ＜００１）。而胃窦蠕动波持续时间和血中胃泌素浓度，正常组和ＦＤ组服药前后均无显著差异（Ｐ＞００５）。结论：ＦＤ与胃动力障碍有关，西沙必利治疗ＦＤ是合理、有效的     

胃癌及消化性溃疡患者胃窦粘膜胃肠激素的变化

目的探讨胃癌及消化性溃疡（ＰＵ）患者胃窦粘膜胃肠激素变化的意义．方法内镜及活检确诊的浅表性胃炎（ＣＳＧ）１０例，胃溃疡（ＧＵ）１５例，十二指肠溃疡（ＤＵ）１２例，胃癌（ＧＣ）６例．胃镜下取胃窦粘膜，用ＲＩＡ法测定胃泌素（Ｇａｓ）、生长抑素（ＳＳ）、Ｐ物质（ＳＰ）的含量，各组间进行比较．结果胃窦粘膜ＳＳ含量在ＧＵ，ＤＵ，ＣＳＧ，ＧＣ组分别为２５１ｐｇ／ｍｇ±１９４ｐｇ／ｍｇ（以下同），４７０±１７９，５３２±２１１及１２９３±５２３。其中ＧＵ组低于其余各组（Ｐ＜００５），而ＧＣ时则显著升高（Ｐ＜００１）．ＳＰ含量在ＤＵ组显著降低，与ＧＵ，ＣＳＧ，ＧＣ比较分别为４７９±１５７ｖｓ７６５±４１５，７８９±３９０及８０１±３４６，Ｐ＜００５；ＧＣ患者Ｇａｓ水平显著高于ＣＳＧ组，为４６４５±２９４４，ｖｓ２７６８±１５７２，Ｐ＜００１．结论胃粘膜中Ｇａｓ，ＳＳ，ＳＰ含量的变化可能在ＰＵ及胃癌的发病机理中起重要作用．     

冬虫夏草多糖治疗慢性丙型肝炎患者的临床研究

目的研究冬虫夏草多糖（ＣＰ）治疗慢性丙型肝炎的疗效．方法慢性丙型肝炎患者２１例，口服ＣＰ１５ｍＬ，３次／ｄ，连服３ｍｏ，治疗前后检测肝功能、血清肝纤维化标志物外周血Ｔ细胞亚群及ＮＫ活性的变化．结果慢性丙型肝炎患者经ＣＰ治疗后，血清ＡＬＴ（Ｕ／Ｌ，６１±３５ｖｓ３５±１５）及ｒＧＴ（Ｕ／Ｌ，１６９±８５ｖｓ１１８±５２）较治疗前显著降低（Ｐ＜００５）．血清ＨＡ（μｇ／Ｌ，２９３±１０９ｖｓ２１４±９６）、ＰⅢＰ（μｇ／Ｌ，１４３±４８ｖｓ１１４±４２）及ＣⅣ（μｇ／Ｌ，２４５±９８ｖｓ１８８±８７）均较治疗前显著下降（Ｐ＜００１，＜００５及＜００５）；ＣＤ４（３６４％±６６％ｖｓ４１０％±５６％）、ＣＤ４／ＣＤ８（１１４±０４０ｖｓ１４３±０２２）、ＮＫ（１６７％±４６％ｖｓ１９７％±４２％）均较治疗前显著增加（Ｐ＜００１），而ＣＤ８（３２６％±４７％ｖｓ２８９％±３７％）则明显降低（Ｐ＜００５）；血清胆红素略减、清蛋白略增但差异均无显著性．结论冬虫夏草多糖可以增强慢性丙型肝炎患者细胞免疫功能，改善肝功能，并具有一定的抗纤维化作用     

郁金对血浆生长抑素水平的影响

本实验观察口服郁金煎剂后，血浆生长抑素水平的变化。观察对象为轻度慢性浅表性胃炎病人，观察组２０例，对照组１８例。结果：口服郁金煎剂前血浆生长抑素水平为６８．２９±１３．５２ｐｇ／ｍｌ，服药后３０ｍｉｎ和６０ｍｉｎ分别为１２１．３５±２０．０８ｐｇ／ｍｌ、１０９．３２±１８．５１ｐｇ／ｍｌ，均高于服药前，差异显著（Ｐ＜０．０１）。揭示郁金有促进生长抑素释放的作用。     

糖尿病患者血清生长激素与肌酐清除率

测定了１６例胰岛素依赖型糖尿病（ＩＤＤＭ）患者，１９例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者和２３例对照者的血清生长激素（ＧＨ）水平。在ＩＤＤＭ组，无论是肌酐清除率（Ｃｃｒ）正常或减低，其ＧＨ值均为２．５３±１．７３μｇ／Ｌ，均高于对照组的０．７１±０．５３μｇ／Ｌ（Ｐ＜０．０５），ＧＨ与Ｃｃｒ呈负相关（ｒ＝０．６３，Ｐ＜０．０１），ＮＩＤＤＭ组Ｃｃｒ＜５０ｍｌ／ｍｉｎ者ＧＨ值为１．８３±０．４７μｇ／Ｌ显著高于对照组（Ｐ＜０．０５）和Ｃｃｒ＞８０ｍｌ／ｍｉｎ组（ＧＨ０．８３±０．４９μｇ／Ｌ，Ｐ＜０．０５）。糖尿病（ＤＭ）伴微血管并发症者，ＧＨ值为２．９２±１．７０μｇ／Ｌ，高于无此并发症者ＧＨ１．２４±０．９７μｇ／Ｌ，（Ｐ＜０．０１），认为ＧＨ与ＤＭ微血管并发症有关。     

老年肺部感染患者白细胞介素2活性的变化

对５０例老年肺部感染患者白细胞介素２（ＩＬ－２）的活性进行了测定。结果表明：老年肺部感染患者ＩＬ－２活性（４．１±４．０Ｕ／ｍｌ）显著低于健康老年人（１３．０±１０．１Ｕ／ｍｌ）（Ｐ＜０．００１），亦明显低于非老年肺部感染患者（７．２±５．４Ｕ／ｍｌ）（Ｐ＜０．０５）。肺部急性感染患者当感染控制后ＩＬ－２活性显著回升（１１．１±７．５Ｕ／ｍｌ）（Ｐ＜０．００１）。此外，病程＞４年的老年肺结核患者ＩＬ－２活性（２．８±２．０Ｕ／ｍｌ）低于病程＜４年的患者（７．７±５．７Ｕ／ｍｌ）（Ｐ＜０．０５）；重症患者（２．９±２．８Ｕ／ｍｌ）低于轻症患者（８．５±５．４Ｕ／ｍｌ）（Ｐ＜０．０１）。提示肺部感染及肺结核的严重程度和病程均可影响老年患者的ＩＬ－２活性。ＩＬ－２可反映老年肺部感染患者的免疫状态。     

木香对犬的胃酸及血清胃泌素、血浆生长抑素浓度的影响

为探索木香对胃酸、胃泌素及生长抑素的影响，以明确其治疗消化性溃疡的机制。本研究对带有海氏小胃的犬，经口灌入１０ｇ｜４０ｇ两种剂量的木香煎剂或蒸馏水２０ｍｌ做为对照组，观察小胃排酸量，并用放免法测定血中胃泌素和生长抑素浓度。结果表明：木香对胃酸及血清胃泌素浓度无任何影响（Ｐ＞０．０５），而在灌入木香３０ｍｉｎ后血浆生长抑素较对照组明显升高（Ｐ＜０．０５）。结论：木香能促进生长抑素的分泌，可能有益于消化性溃疡的治疗     

老年非溃疡性消化不良患者胃液体排空与血浆胃动素、生长抑素关系的研究

采用实时超声显像法与放射免疫法,对20例老年NUD患者及15例对照者进行胃液体排空时间的测定及血浆胃动素、生长抑素的检测,探讨老年NUD患者目排空运动与胃肠激素之间的关系.结果显示:老年NUD患者胃液体排空T1/2为39.00±11.65min,较对照组的29.33±7.99min明显延迟(P<0.01).老年NUD患者胃动素浓度为471.5±63.06pg/ml,生长抑素浓度为63.83±11.88pg/ml,较对照组分别下降和升高(P均<0.01).老年NUD患者胃液体排空T1/2与胃动素浓度呈负相关(r=-0.936,P<0.01),与生长抑素浓度呈正相关(r=0.942,P<0.01).表明老年NUD患者胃液体排空障碍与胃动素分泌下降及生长抑素分泌增高相关.     

胃十二指肠疾病与血浆激素关系的初步研究

对64例胃十二指肠疾病患者(包括慢性残表性胃炎23例,萎缩性胃炎5例,胃溃疡10例,十二指肠溃疡14例及胃癌12例)的血浆生长抑索(SS)、血管活性肠肽(VIP)、胃动素(MTL)及血清胃泌素(Gas)的研究表明,血浆SS水平在胃十二指肠溃疡组及胃癌组均低于正常对照组(P<0.001);血浆VIP浓度在胃溃疡时升高最明显,与正常组及各疾病组比较均有显著性差异(P<0.01);十二指肠溃疡及胃癌组的血浆MTL含量均高于正常对照组(P<0.05);血清Gas水平在浅表性胃炎和萎缩性胃炎时均高于正常对照组(P<0.01).     

Effect of environmental hyperthermia on gastrin, somatostatin and motilin in rat ulcerated antral mucosa

AIM: To study the effect of environmental hyperthermia on gastrin, somatostatin and motilin in rat ulcerated antral mucosa.METHODS: Forty-two Wistar rats were equally divided into six groups, according to the room temperature (high and normal) and the treatment (acetic acid, normal saline and no treatment). Levels of gastrin, somatostatin and motilin in rat ulcerated antral mucosa were measured with a radioimmunoassay method.RESULTS: The average temperature and humidity were 32.5℃ and 66.7% for the high temperature group, and 21.1℃ and 49.3% for the normal temperature group,respectively. Gastric ulcer model was successfully induced in rat injected with 0.05 mL acetic acid into the antrum. In rats with gastric ulcers, the levels of gastrin and motilin increased, whereas the somatostatin level declined in antral mucosa, compared with those in rats treated with normal saline and the controls. However, the change extent in the levels of gastrin, motilin and somatostatin in antral mucosa was less in the high temperature group than in the normal temperature group.CONCLUSION: The levels of gastrin, somatostatin and motilin in rat ulcerated antral mucosal tissue remain relatively stable in a high temperature environment, which may relate to the equilibration of the dynamic system.     

Neuroendocrine peptides of the gastrointestinal tract of an animal model of human type 2 diabetes mellitus

We studied ten obese diabetic mice (Umeå/ Bom-ob) and 10 homozygous lean controls aged 21 weeks. The concentration of several neuroendocrine peptides was determined by radioimmunoassay of tissue extracts of antrum, duodenum and distal colon. The neuroendocrine peptides that we investigated were: secretin, gastric inhibitory polypeptide (GIP), gastrin, motilin, peptide YY (PYY), somatostatin, vasoactive intestinal polypeptide (VIP), substance P, neurotensin, neuropeptide Y (NPY) and galanin. In the antrum, gastrin, somatostatin, VIP, substance P and NPY concentrations were significantly lower in obese diabetic mice than in the lean controls. There was no statistical difference between the obese mice and lean controls for neurotensin and galanin content. In the duodenum, the concentration of substance P was lower in the obese diabetic mice than in lean mice. There was no statistical difference between obese diabetic mice and lean controls regarding the concentration of secretin, GIP, motilin, gastrin, somatostatin, VIP, neurotensin, NPY or galanin. In the colon, the levels of PYY, somatostatin, VIP, substance P, NPY and galanin were significantly lower in the obese diabetic mice than the lean controls. The concentration of neurotensin in the obese mice did not differ from that in the lean controls. The present study showed that the neuroendocrine system is disturbed in an animal model of human type 2 diabetes and that this disturbance differs from that observed in other animal models of human type 1 diabetes. The present findings may have some implications for the gastrointestinal dysfunction observed in patients with type 2 diabetes.     

Plasma levels of gastrointestinal regulatory peptides in patients receiving maintenance hemodialysis.

The fasting plasma levels of 9 gastrointestinal regulatory peptides were measured by radioimmunoassay in 13 stable patients with chronic renal failure receiving hemodialysis treatment regularly and compared with those of 10 healthy controls. The plasma concentrations of gastrin-releasing peptide, motilin, neurotensin, pancreatic polypeptide, peptide YY, somatostatin, substance P, and vasoactive intestinal peptide were increased. The plasma level of gastrin was not statistically different from that of the controls (p = 0.077). We conclude that patients with chronic renal failure receiving hemodialysis treatment regularly have increased concentrations of eight of nine measured gastrointestinal regulatory peptides. The elevated levels of gastrointestinal peptides in patients with chronic renal failure may contribute to uremic gastrointestinal symptoms and dysfunctions. It is necessary to make a renal function evaluation before interpreting measured plasma levels of gastrointestinal regulatory peptides.     

肝郁脾虚患者血清胃泌素、胃动素的初步观察

我们测定了２３例慢性乙肝患者血清胃泌素、胃动素并且将其结果与肝郁脾虚证相联系。结果表明肝郁脾虚证患者血清胃泌素、胃动素异常率明显高于肝郁证患者，进一步分析发现脾虚症状的形成似乎伴随着这两种激素的异常。使用某些中草药可以纠正脾虚症状及异常的血清胃泌素、胃动素。     

Hypersomatostatinaemia in duodenal ulcer

Abstract A sensitive and specific radioimmunoassay of serum somatostatin has been developed that overcomes the problems encountered in earlier assays of peptide disintegration and the need for prior plasma extraction, which is known to result in artifactual loss of somatostatin. In 37 normal controls, a significant positive correlation between fasting serum gastrin and somatostatin concentrations, and a significant negative correlation between pentagastrin-stimulated maximal acid output and fasting serum somatostatin levels were observed. In the majority of 134 patients with active duodenal ulcer in whom the fasting serum somatostatin levels were normal, these relationships were absent. In the remaining 25% in whom the fasting serum somatostatin levels were abnormally raised, these relationships were retained. Following a mixed meal, circulating somatostatin levels remained unchanged in controls and patients as a group. These results suggest that: (i) in the normal state, fasting levels of circulating gastrin and somatostatin are closely related, and that acid secretion may paradoxically exert an inhibitory effect on fasting somatostatin levels; (ii) hypersomatostatinaemia identifies a subgroup of patients with duodenal ulcer in whom these relationships are retained; and (iii) somatostatin may not have a significant hormonal role in the postprandial state in man.     

Sphincter of Oddi hypomotility and its relationship with duodenal-biliary reflux, plasma motilin and serum gastrin

AIM： To detect whether patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux by measuring the radioactivity of Tc99m-labeled diethylene triamine penta-acetic acid （DTPA） in the bile and whether the patients with duodenal-biliary reflux have sphincter of Oddi hypomotility, by measuring the level of plasma and serum gastrin of the patients. Finally to if there is close relationship among sphincter of Oddi hypomotility, duodenal-biliary reflux and gastrointestinal peptides.
METHODS： Forty-five patients with a T tube after cholecystectomy and choledochotomy were divided into reflux group and control group. The level of plasma and serum gastrin of the patients and of 12 healthy volunteers were measured by radioimmunoassay. Thirty-four were selected randomly to undergo choledochoscope manometry. Sphincter of Oddi basal pressure （SOBP）, amplitude （SOCA）, frequency of contractions （SOF）, duration of contractions （SOD）, duodenal pressure （DP） and common bile duct pressure （CBDP） were scored and analyzed.
RESULTS. Sixteen （35.6%） patients were detected to have duodenal-biliary reflux. SOBP, SOCA and CBDP in the reflux group were much lower than the control group （t = 5.254, 3.438 and 3.527, P 〈 0.001）. SOD of the reflux group was shorter than the control group （t = 2.049, P 〈 0.05）. The level of serum gastrin and plasma motilin of the reflux group was much lower than the control group （t = -2.230 and -2.235, P 〈 0.05）. There was positive correlation between the level of plasma motilin and SOBP and between the level of serum gastrin and SOBP and CBDP.
CONCLUSION： About 35.9% of the patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux. Most of them have sphincter of Oddi hypomotility and the decreased level of plasma motilin and serum gastrin. The disorder of gastroin-testinal hormone secretion may result in sphincter of Oddi dysfunction. There is a close relationship between sphincter     

血浆胃动素与小肠传递时间关系的初步探讨

应用国产乳果糖-氢气呼吸试验法及放射免疫法同步探测了32例正常人及20例非溃疡消化不良(NUD)患者血浆胃动素(MTL)及小肠传递时间(SBTT)。结果发现MTL与SBTT有显著负相关关系(r=-0.8283,P<0.01)。即MTL含量越高,SBTT越短,提示内源性MTL可加速SBTT。NUD患者其平均MTL/SBTT比值为2.3:1,较正常人(4.7:1)降低50％。表明NUD与血浆MTL的分泌释放量减少有关。这对揭示NUD发病机制及开辟新的治疗途径具有一定意义。     

肠易激综合征回盲部肥大细胞及结肠粘膜中胃肠激素的研究

为探讨肠易激综合征（ＩＢＳ）回盲部肥大细胞及结肠粘膜中胃肠激素有无变化，以及它们在ＩＢＳ中的可能作用和临床意义，应用组化特染法及放射免疫分析法将对照组和ＩＢＳ组对比研究，结果ＩＢＳ组回盲部肥大细胞计数明显增多（Ｐ＜０．０５）；结肠粘膜中生长抑素的含量ＩＢＳ组明显高于对照组，痛秘型ＩＢＳ明显高于痛泻型ＩＢＳ（Ｐ＜０．０５）；胆囊收缩素、胃动素和Ｐ物质的含量两组无明显差别（Ｐ＞０．０５）。研究提示回盲部肥大细胞及结肠粘膜中的生长抑素在ＩＢＳ的病生机制中起有一定的作用，肥大细胞稳定剂或肥大细胞产物拮抗剂可能对ＩＢＳ具有治疗作用。