日前，国际著名专业杂志《胃肠病学》（Gastroenterology）刊出了遵义医学院庹必光教授和美国加州大学圣地亚哥分校的董辉博士的合作研究论文“Estrogen Regulation of Duodenal Bicarbonate Secretion and Sex-Specific Protection of Human Duodenum”。当期，《胃肠病学》杂志封面推荐了该文章。
此项研究是对我国西南地区“十二指肠溃疡”病的发病情况调查统计的基础上，发现该病的发生率存在着明显的性别差异，即成年女性罹患十二指肠溃疡的比例显著低于男性（4-5倍），但绝经以后女性的发病率就与男性相差无几了。随后，研究进一步揭示了其中的原因。我们知道，分泌碳酸氢盐是十二指肠粘膜用来抵御胃酸损害的重要屏障，碳酸氢盐分泌的减少与十二指肠溃疡的发生、发展相关。本研究发现，绝经前的女性，其十二指肠粘膜碳酸氢盐的分泌在基础和酸刺激条件下均明显高于同龄对照组的男性，而两性间的此种差异在女性绝经后就消失了；而且，性成熟期女性十二指肠粘膜碳酸氢盐的分泌是随血液中雌激素水平的变化而变化的，位于十二指肠粘膜上皮的雌激素受体介导了这一过程。
此项研究是在国家自然科学地区基金项目（30860092）等经费资助下完成的。
相关英文论文摘要：
Estrogen Regulation of Duodenal Bicarbonate Secretion and Sex-Specific Protection of Human Duodenum
Background & Aims
The reason that women have a lower prevalence of duodenal ulcer is not clear. We investigated whether estrogen regulates human duodenal bicarbonate secretion (DBS) and whether this process accounts for sex differences in the prevalence of duodenal ulcer.
Methods
We performed an epidemiologic study to correlate duodenal ulcer prevalence with sex and age. Proximal DBS was measured from healthy subjects. Estrogen-receptor expression was examined in human duodenal mucosa by immunoblot and immunohistochemical analyses.
Results
Among women, the prevalence of duodenal ulcer was significantly lower than among men. The reduced prevalence was greatest among premenopausal women (20—49 y), who were 3.91- to 5.09-fold less likely to develop duodenal ulcers than age-matched men; the difference was reduced to 1.32-fold or less among subjects aged 60 years or older. Premenopausal (20—29 y), but not postmenopausal (60—69 y), women had significantly higher basal and acid-stimulated DBS than the age-matched men. Basal and acid-stimulated DBS in premenopausal women (20—29 y) were significantly higher than in postmenopausal women (60—69 y), whereas there were no significant differences in basal or acid-stimulated DBS between men who were aged 20—29 years or 60—69 years. Serum levels of estradiol changed in parallel with basal and acid-stimulated DBS during the physiological menstrual cycle in premenopausal women. 17β-estradiol–stimulated DBS was independent of age or sex. Estrogen receptors α and β were detected on plasma membranes and in the cytosol of human duodenal epithelial cells.
Conclusions
Estrogen regulates human DBS, which could reduce the risk for duodenal ulcer in women and contribute to sex differences in the prevalence of duodenal ulcer.
