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Stomach and Intestine(Tokyo) Volume 13, Issue 2 （February 1978）

胃と腸 13巻2号（1978年2月発行）

Japanese English

研究

急性胃潰瘍の病態生理 Pathophysiology of Acute Gastric Ulcer 須山哲次 ¹ , 井上正規 ¹ , 浦城三四郎 ¹ , 中村正義 ¹ T. Suyama ¹ , M. Inoue ¹ , S. Uraki ¹ , M. Nakamura ¹ ¹広島大学医学部第1内科 ¹1st Division of Internal Medicine, School of Medicine, Hiroshima University pp.213-222

発行日 1978年2月25日 Published Date 1978/2/25

DOI https://doi.org/10.11477/mf.1403107217

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Abstract 文献概要
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　急性胃潰瘍は形態的にも病理学的にも，慢性のそれと必ずしも同質ではないと推測される幾つかの所見がある．したがって急性胃潰瘍の慢性転化あるいは移行の可能性が疑問視され，解決をみていない．

　著者らは，急性胃潰瘍の範疇に急性の粘膜erosionをも含めて，実験的ならびに臨床的に得られた病態生理の一端を紹介し，若干の文献的考察を加えたいと思う．

　We appraised two factors, stress and disruption of barrier in the gastric mucosa, as the origin of acute gastric ulcer clinical and experimental observations were done to elucidate the mechanism of mucosal injury supposedly caused by these factors.

　Concomitant with accelerated stage of mucosal injury, rats with stress due to restriction of movement showed in the gastric mucosa 12 hours after detention significant increase of histidine decarboxylase activity, carbonic anhydrase activity, peptic activity and circulating gastrin.

　When the pylorus of a fasting rat was ligated, the amount of gastric juice and peptic activity increased, but acidity began to decrease eight hours after ligation. When after ligation highly concentrated hydrochloric acid was injected into the stomach, only the acidity of the gastric juice decreased definitely four hours later. These results seem to suggest back diffusion of acid. Introduction of aspirin into the stomach with the pylorus ligated showed a sharp decrease in the degree of hydrochloric acid and the amount of acid secretion in four hours, but in 12 hours later they were restored. In both stages we observed multiple erosions of gastric glands. Introduction of taurocholic acid into the ligated stomach produced decrease of acidity in not only four hours but 12 hours as well. The effect of aspirin on the mucosal barrier is transient.

　Injection of aspirin into the human stomach showed decrease in H⁺ and Cl^- and increase of Na⁺. In 43 per cent was seen bile in the gastric juice in those who took ASA continuously. In the group of gastric ulcer accompanied with mucosal erosion the concentration of total bile acid and lysolecithin was several times as thick as in those of other diseases. Correlation was also seen between the occurrence of erosion in the antrum and regurgitation of bile as well as the degree of acidity of the gastric juice.