Журнал "Гастроэнтерология" Том 56, №3, 2022
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The factors of aggression and protection of the mucous membrane of the stomach in patients with hiatal hernia
Авторы: A.M. Halinska, N.V. Prolom, O.O. Halinskyi
SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro, Ukraine
Рубрики: Гастроэнтерология
Разделы: Медицинские форумы
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The aim of the article: to assess the state of secretion of the gastric mucosa in case of hiatal hernia (HH).
Materials and methods. The study was conducted in 54 patients with hiatal hernia who were undergoing inpatient treatment at the Institute of Gastroenterology of the National Academy of Sciences of Ukraine. The control group consisted of 40 healthy people. Gastric juice was collected during endoscopic examination. The pH of gastric juice and the concentration of pepsin were determined. The functional activity of the surface epithelial cells of the gastric mucosa was determined in the gastric juice by the concentration of total glycoproteins, the level of sialic acids, fucose and glycosaminoglycans.
Results. In patients with hernias of the esophageal ope–ning of the diaphragm, the acid type of secretion prevailed, the average pH value for the group was (3.64 ± 0.33), which is 45 % (р < 0.05) higher compared to the values of the control group, which indicates a somewhat lower functional activity of parietal cells. The activity of the main cells of the glands of the mucous membrane of the stomach, according to the pepsin concentration of the gastric juice ((0.77 ± 0.11) mg/ml), tended to increase by 25 %. The concentration of glycoproteins in gastric juice was at the level of (0.16 ± 0.02) mg/ml, which is 60 % (p < 0.05) higher compared to the control, which indicates a compensatory increase in mucus production by surface epithelial cells of the gastric mucosa in response on increasing the aggressiveness of gastric juice caused by an increase in the concentration of pepsin. Against the background of an increase in the concentration of glycoproteins, there is a multidirectional violation of the ratio of their components. Concentrations of fucoses ((0.56 ± 0.06) mmol/l) and glycosaminoglycans ((0.68 ± 0.07) mmol/l) were lower by 51 % (p < 0.01) and 24 % (p < 0.05), and sialic acids ((0.36 ± 0.05) mmol/l), on the contrary, higher by 304 % (р < 0.01) compared to the values of the control group.
Conclusions. Gastric secretion of patients with hernias of the esophageal opening of the diaphragm was acidic with the preserved functional activity of the main and surface epithelial cells of the glands of the gastric mucosa. It was established that against the background of an increase in the concentration of glycoproteins, there is a multidirectional violation of the ratio of their components. It was found that against the background of an increase in the concentration of sialic acids, there is a violation of the ratio of the components of the protective factors of the gastric mucosa.