小児の胃内 pH の研究 : 健常児ならびに小児消化性潰瘍患児について

抄録

By using the small, wired, glass electrode diveloped by the auther for pediatric use, the intra-gastric pH mesurements were done and characteristcs of peptic ulcer in pediatric patients were studied. The subjects were 82 cases of pediatric group which included 31 cases of duodenal ulcer, 10 cases of gastric ulcer, and 41 non-ulcer children, and 173 cases of adult group which included 65 cases of duodenal ulcer, 87 cases of gastric ulcer, and 21 healthy peasons. The pH value in the fasting stomach early in the morning was taken as the basal pH value for this study. Results obtained were as follows : 1. It was found that both duodenal ulcer and gastric ulcer had the tendency of sudden increase in the age group over 8 years, and that the upper abdominal pain, abdominal distension and nausea and/or vomiting were the major symptoms of pediaric duodenal ulcer whereas upper abdominal pain and nausea and/or vomiting were the 2 major symptoms of pediatric ulcer. 2. The average basal pH values of non-ulcer group were 2.0±0.5 in neonates, 1.6±0.5 in infants, 1.9±0.5 in pre-school children, 1.5±0.3 in school children, 1.7±0.3 in middle school children, and 1.7±0.2 in adults. 3. The average basal pH value of peptic ulcer cases was in children of duodenal ulcer 1.1±0.2 which abnormally low against that of 1.7±0.5 in children of gastric ulcer. In adults, in the duodenal ulcer group, it was 1.4±0.4 while in gastric ulcer group, it was 2.4±1.1. These results revealed the fact that in children the aggresive factor was more strongly involved than in adult cases. 4. The blood gastrin levels in 17 cases of pediatric peptic ulcer, measured early in the morning under fasting condition, were average 72.9±10.7 pg/ml in duodenal ulcer and average 66.9 pg/ml in gastric ulcer group, respectively, which were higher than the values obtained of healthy children as reported by many investigators. 5. The changes of basal pH values by time passage of the 12 cases of peptic ulcer children given oral medication were studied. The oral medication had caused subjective symptoms to easily disappear and cure of ulcers, but none of the cases had the basal pH values reached the non-acid levels. 6. Out of 4 pediatric duodenal ulcer cases on which operation was performed, 3 cases showed the tendency of pH increase to the lowor non-acid levels soon after the operations. 7. The intragastric pH determination by using the small, wired electrode was very effective clinically not only for diagnosis of pediatric peptic ulcers but also for observing the effect of therapies.