尼古丁影响胃粘膜血流量和胃酸分泌

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在临床上经常观察到,吸烟者胃及十二指肠溃疡的发病率要比不吸烟者高得多,同时,其消化性溃疡的愈合率也低。这是否与上消化道粘膜血流量减少、粘膜的完整性受到破坏的因素有关?最近,德国Sonnenberg等分别通过静脉内滴注尼古丁(nicotine)和直接吸烟,观察对胃粘膜血流量和胃酸分泌的影响。实验在八名不吸烟的和五名吸烟的、无上消化道病史的成年健康男性身上进行。实验前一天晚上禁食。整个实验时间为四小时,在前两小时,由静脉滴注五肽胃泌素;在后两个小时,(1)将不吸烟者分成四组,由静脉同时滴注五肽胃泌素和不同剂量(2.5、5、7.5、10μg/kg/hr)尼古丁;(2)给五名吸烟者各吸入香烟5支(每支含尼古丁0.4mg)。在实验开始时,受试者静脉内给予一定量中性红,然后按规定时间抽血,测定胃中性红清除率,作为反映胃粘膜血流量的指标,同时,通过胃管抽取胃液测定胃液量、胃酸排出量以及R值(即胃中性红清除率和胃分泌量的比率)。在实验的第二小时,上述各项指标均达到稳定状态,作为正常值。此时,胃液量为80ml/15min、胃酸分泌量为7.5mMol/15min,中性红清除率为74ml/min左右,R值为14。当静脉滴注不同剂量尼古丁后,胃液量、胃酸排出量、中性红清除率均降低,尤以前两者所受的抑制作用更为明显,R值升高,而且 It is often clinically observed that the incidence of gastric and duodenal ulcer in smokers is much higher than that in non-smokers and the healing rate of peptic ulcer is also low. Is this related to the reduction of upper gastrointestinal mucosal blood flow, mucosal integrity of the destruction of the factors? Recently, Germany Sonnenberg, respectively, by intravenous infusion of nicotine and direct smoking, observe the gastric mucosal blood flow and gastric acid secretion influences. The experiment was conducted on eight non-smokers and five smokers of healthy adult men with no upper gastrointestinal history. Fasting the night before the experiment. The entire experiment period was four hours. In the first two hours, the pentagastrin was instilled intravenously. In the second two hours, (1) the non-smokers were divided into four groups and the pentagastrin Nicotine at various doses (2.5, 5, 7.5, 10 μg / kg / hr); and (5) 5 cigarettes (0.4 mg each containing nicotine) for each of five smokers. At the beginning of the experiment, the subjects were intravenously given a certain amount of neutral red, and then according to the prescribed time of blood, determination of gastric neutrophil clearance rate, as an indicator of gastric mucosal blood flow indicators at the same time, gastric juice by gastric juice was measured gastric juice Amount of gastric acid excretion and R value (ie, the ratio of gastric redness and gastric secretion). The second hour of the experiment, the above indicators have reached a steady state, as a normal value. At this time, gastric juice volume was 80ml / 15min, gastric acid secretion was 7.5mMol / 15min, neutral red clearance rate of about 74ml / min, R value of 14. After intravenous infusion of different doses of nicotine, gastric juice volume, gastric acid output, neutral red clearance rate were reduced, especially the former two suffered more pronounced inhibition, R value increased, and
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