胃、十二指肠疾病时胃粘膜血流量的变化

CHANGES OF GASTRIC MUCOSAI BLOOD FLOW IN PATIENTS WITH GASTRIC OR DUODENAL DISEASE

在氢气清除法(HGC)和激光多普勒测血流(LDF)法同时测定大鼠胃粘膜血流量(GMBF),证明二者相关和得到可将LDF测得的相对量换算成HGC的绝对血流量的基础上,用LDF测定了胃溃疡(GU)和十二指肠溃疡(DU)患者的GMBF。重点观察了用Cytotec和雷尼替丁治疗后GU愈合过程中GMBF的改变。结果表明,活动期(A期)GU的GMBF显著低于正常对照组;与GU不同,A期DU的GMBF与正常对照组相比无明显变化,反映了二者发病机理的不同。两治疗组,随着溃疡的愈合GMBF均恢复正常。但Cytotec组溃疡边缘GMBF的增加幅度大于雷尼替丁组者,由此提示溃疡愈合过程中GMBF的增加主要是其本身的病理生理变化过程,而对GMBF有影响的抗溃疡药物似不起主要用。

The gastric mucasal blood flow (GMBF) of patients with grstric ulcer (GU) or duodenal ulcer (DU) by laser Doppler flowmetry(LDF) was measured on the basis of proving the close correlation and establishing the linear regression equation between GMBFs measured in rats by LDF and hydrogen gas clearance. The emphasis was the changes of GMFB n patients with GU after treatment with cytotec or ranitidine. The results were as follows: 1. GMBF of patients with active GU was markedly decreased as compared with that of normal controls. 2. With healing of GU, GMBF of all patients restored to normal level, regardless of treatment with cytotec or ranitidine, but over the margin of ulcer the increased amplitude of GMBF in patients treated with cytotec was higher than thta treated with ranitidine. 3. In contrast to GU, GMBF of those with active DU remained unchanged. It is suggested that the restoration of GMBF in patients with GU may be mainly the pathophysiological changes during ulcer healing process rather than the effect of anti-ulcer drugs, and that decreased GMBF in active GU and unchanged GMBF in active DU may reflect the difference in pathogenesis between GU and DU.