Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.


佐藤 公康 岡山大学医学部第一内科教室
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There have been many reports on the alterations in the blood constituents levels of patients with stomach ulcer. Some reporters stated anemia, hypoproteinemia, hypoalbuminemia, decreased serum cholinesterase activity and serum iron in the cases of stomach ulcer; but other noticed that levels of blood constituents in patient with stomach ulcer were amost within normal range. An investigation of the difference between the levels of the blood constituents of the normal and of the stomach ulcer cases was attempted. One hundred and fifty one cases of normal, 286 cases of stomach ulcer and 266 cases of stomach cancer were examined. The measured blood constitueuts were RBC, hemoglobin concentration, hematocrit, WBC and blood group. The serum constituents such as cholinesterase, alkaline phosphatase, cholesterol, glutamic pyruvic transaminase, phenol turbidity test, amylase, non-protein nitrogen, sugar, iron, copper, protein and its fractions, mucoprotein and its fractions and lipoprotein were also determined. The significant changes were statistically discussed. Decreases of RBC, hemoglobin concentration, Ht, serum cholinesterase activity, serum iron, serum albumin, A/G ratio and mucoprotein-albumin, and increases of WBC, serum GFT activity, serum amylase activity, serum NPN and globulin fraction of serum protein were noticed in the cases of stomach ulcer. It is supposed that anemia and decreased serum iron are due to the continuous bleeding from ulcer, hypoalbuminemia and decreased serum cholinesterase activity and increased GPT activity are to general deterioration by maluntrition and liver damage accompanied with stomach ulcer. Increase of serum amylase activity and serum NPN may be the sequences of pancreatic and renal involvements, the latter might be followed by the ulcer hemorrhage and dehydration. The blood constituents levels in the cases with stomach ulcer which needed the operation showed more advanced anemia and hypocholinesterasemia than in the whole ulcer cases. In the cases with large ulcer, decreased cholinesterase activity and increased NPN were prominent. The comparison of blood levels in the stomach cancer with in the stomach ulcer revealed that decreased RBC, hemoglobin concentration, serum cholinesterase activity, serum iron, gamma-globulin fraction and mucoprotein-albumin and increased alkaline phosphatase activity were significant in the group of stomach ulcer. The blood constituents levels in stomach ulcer group were situated between normal and stomach center group in regard to anemia, general deterioration and liver damage; but in the cases of large ulcer, some constituents such as serum cholinesterase, serum amylase and serum NPN were in worse condition than in the stomach cancer cases. Relationship between stomach ulcer and liver function disturbance was significantly observed in blood spectrum. Anemia, malnutrition and accompanied gastritis with stomach ulcer may induce secondary chronic liver damage, but severe liver disorder occurs rarely in the cases with stomach ulcer.