Pentapeptide gastrin gastric juice analysis
The analysis of pentagastrin gastrin gastric juice is an important auxiliary means for diagnosing gastroduodenal diseases. The preferred method for judging gastric acid function has its special value in the research and therapeutic monitoring of acid-related diseases. The fasting gastric juice was drained and discarded, and then the gastric juice was continuously extracted for 1 hour, and the amount of gastric juice was measured, which was the basic basal acid output (BAO). After measuring BAO, 6 μg of pentagastrin was injected subcutaneously or intramuscularly per kilogram of body weight, and gastric juice was taken once every 15 minutes for 4 times. The amount of gastric juice (ml) was recorded, and the acidity was measured, and the results of 4 titrations were added. It is the maximum gastric acid output (MAO) of 1h. The sum of the two consecutive highest acid numbers multiplied by 2 is the peak acid output (PAO). Normal people's BAO is more affected by factors such as nerve and endocrine, and the variation is larger and the repeatability is poor.Basic Information
Specialist classification: Digestive examination classification: body fluid examination
Applicable gender: whether men and women apply fasting: fastingAnalysis results:
Gastric acid deficiency, stomach acid is too low.
Fasting acid output: 0-5mmol/h
The total amount of fasting gastric juice: 0.01 ~ 0.1L (10 ~ 100ml).
Fasting acid output: 0 ~ 5mmol / h (0 ~ 5mEq / h).
Maximum acid output:
Male <45mmol/h (45mEq/h).
Female <30mmol/h (<30mEq/h).
1, gastric acid deficiency (stomach liquid pH can not be reduced to 7.0 or less) found in pernicious anemia, atrophic gastritis, severe iron deficiency anemia, total gastrectomy, gastric cancer (a few).
2, gastric acid is too low (gastric fluid pH can not be reduced to 3.5 or less, but less than 7.0) found in hypoacidemia, atrophic gastritis, iron deficiency anemia, B vitamin deficiency, partial gastric cancer, adrenal insufficiency, anterior pituitary Hypofunction, etc.Low results may be diseases: peptic ulcer, digestive ulcer, carcinoid syndrome in the elderly
The drug affecting gastric acid secretion was stopped 24 to 48 hours before the gastric juice was taken.Inspection process
1. Stop taking all antacids, anticholinergic and adrenocortical hormones within 48 hours before the test.
2, fasting and ban drinking for one night, the next morning nasal insertion into the stomach tube, the depth of 50 ~ 60cm. In order to detect whether the end of the stomach tube is at the lowest part of the stomach, it can be used as a water injection recovery test by injecting 20 ml of warm physiological saline from the stomach tube. If more than 16 ml (80%) can be recovered, the stomach tube is at the lowest part of the stomach. 16ml should adjust the depth of the stomach tube until it can recover more than 80% of the injected liquid. The tape fixes the stomach tube.
3. Connect the vacuum suction device and continue to attract at a negative pressure of 4.0 kPa (30 mmHg). Drain the fasting gastric juice and discard it.
4. Continue to aspirate the gastric juice for 1 hour, in a container, record the total amount of gastric juice, leave 5 ml of titrated gastric acid concentration and measure pH. This is the base acid displacement (BAO) with a normal value of 3.28 ± 1.89 mmol / h.
5, intramuscular injection of pentagastrin gastrin 6μg / kg, continue to pump gastric juice under negative pressure, collect gastric juice once every 15 minutes, respectively, in 4 tubes (bottles), measure the amount of gastric juice and pH value, take it 5 ml was sent for examination and the concentration of gastric acid was titrated.
6, gastric acid titration. 5 ml of gastric juice was added with 2 to 3 drops of phenolsulfonate indicator, and titrated with 0.1 mol/L NaOH solution until the gastric juice turns red (pH 7.0), which is the concentration of gastric acid in 5 ml. The formula for calculating the amount of acid secretion is:
Amount of gastric juice (ml) × titration of 5 ml of gastric juice using 0.1 mol/L NaOH amount (ml) × 20 / 1000 = mmol / h.
7. The maximum acid secretion (MAO) is the sum of the acid secretion of the four specimens within 1 h after intramuscular injection of pentagastrin gastrin, and the normal value is 19.34±0.05 mmol/h. The peak acid displacement (PAO) was the highest in the 4 samples within 1 h after intramuscular injection of pentagastrin gastrin. The two largest acid-secreting samples were 2, which was PAO, and the normal was 21.22±9.45 mmol/h.Not suitable for the crowd
Patients with gastric perforation.Adverse reactions and risks
Mucosal injury: Avoid excessive exertion when removing gastric juice from the gastric tube to avoid damage to the nasal cavity and esophageal mucosa.