食後の血中 secretin レベルと胃内pH

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The precise measurement of plasma secretin by radioimmunoassay (RIA) has been possible. We investigated the importance of gastric acid for the release of secretin during digestion. Then, the relation between gastric pH and plasma secretin level after a meal was studied in patients with duodenal ulcer.After an overnight fast, pH electrode was placed nasally in the distal antrum under fluoroscopic control, and antral pH was recorded continuously before and after a meal. A week later, in all subjects, a second meal test was performed, where cimetidine was administered before a meal. Plasma secretin levels were determined by RIA. Prior to RIA, plasma secretin was purified and concentrated from plasma samples by ethanol extraction according to Chey's method. Antral pH was 3.0±0.7 (SE) in fasting and below 2.0 after a meal. In fasting, mean plasma secretin level was 5.0±0.7 (SE) pg/ml, and increased significantly after a meal (8.9±1.8(SE) pg/ml) (p<0.05). On the other hand, the pre-treatment with cimetidine resulted in a marked rise in antral pH. In these cases, no significant increase in plasma secretin occurred after a meal.It was suggested that the release of secretin depended on gastric acid delivered from the stomach to the duodenum, and that the inhibition of gastric acid by cimetidine showed no significant postprandial increase in plasma secretin.
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