Insulin stimulated gastric secretion test

The insulin-stimulated gastric secretion test (hypoglycemia stimulation test) was carried out by the following principle. After the injection of insulin, the blood sugar is significantly reduced, thereby stimulating the vagus nerve. When the vagus nerve is cut off, it does not respond to insulin stimulation, so as to judge the effect of the operation. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Normal value: no Above normal: negative: normal. Positive: 3 or more of the following conditions are positive: 1. The acidity of free hydrochloric acid is 20mmol/L higher than that of basic gastric juice, or the lack of basic gastric acid. The acidity of free hydrochloric acid after injection of insulin is increased by ≥10mmol/L. For example, within 45 minutes after insulin injection, the above standard is early-positive, and 45-120 minutes is delayed. 2. The amount of gastric juice increases. 3. The amount of basal gastric acid secretion was 2 mmol/h. 4. Within 1 h, the total acid secretion was >2 mmol/h. 5. After the injection of insulin, there was an increase in early acid concentration within 1 h. Tips: Inappropriate people: older or suffering from cardiovascular disease, especially those with coronary heart disease who have contraindications for gastric tube. Normal value Negative in this test is normal. 3 or more of the following conditions are positive: 1. The acidity of free hydrochloric acid is 20mmol/L higher than that of basic gastric juice, or the lack of basic gastric acid. The acidity of free hydrochloric acid after injection of insulin is increased by ≥10mmol/L. For example, within 45 minutes after insulin injection, the above standard is early-positive, and 45-120 minutes is delayed. 2. The amount of gastric juice increases. 3. The amount of basal gastric acid secretion was 2 mmol/h. 4. Within 1 h, the total acid secretion was >2 mmol/h. 5. After the injection of insulin, there was an increase in early acid concentration within 1 h. Clinical significance Early positive reaction, suggesting that the vagus nerve is not completely severed, and the positive reaction is negative. The lack of free acid in gastric acid is a negative reaction, indicating that the vagus nerve is completely cut off. Abnormal results: The main clinical manifestations of duodenal ulcers are upper abdominal pain, which may be dull pain, burning pain, pain or severe pain, or it may manifest as pain and discomfort only when starving. Typical manifestations are persistent pain under mild or moderate xiphoid and can be relieved by antacids or eating. About 2/3 of the pain in the clinic is caused by abdominal pain 1 to 3 hours after the rhythmic breakfast. If you do not take the medicine or eat it, it will last until after lunch. It hurts 2 to 4 hours after eating, and it is necessary to eat to ease. About half of the patients have midnight pain and the patient can often wake up. Rhythmic pain lasts for a few weeks and can occur repeatedly with relief for several months. The people who need to be examined: Duodenal ulcer and other diseases are treated with vagus nerve gastrectomy, and the operation needs to be judged after surgery. Positive result may be disease: atrophic gastritis precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. 1. Special attention should be paid to complications during the test, mainly hypoglycemia, and 50% glucose injection, oxygen and other rescue drugs and equipment must be prepared. 2. In order to observe the curative effect, the test is generally performed 2 weeks after the vagus nerve branch or at the follow-up. 3. All kinds of drugs affecting gastric secretion were stopped 3 days before the test, and high protein, high fat food and drinking were stopped. Inspection process method: 1. The diet was banned after dinner on the day before the test, and the fasting blood glucose was measured before the test. 2. On the morning of the test, insert the stomach tube on an empty stomach and drain the gastric juice. 3. After collecting 1 h of basal secretion, intravenous injection of normal insulin 16u-20u (or 0.16u/kg-0.2u/kg body weight). 4. After the injection, the gastric juice was collected once every 15 minutes for a total of 8 times. And observe and record the amount of each gastric juice sample, mucus, bile, blood, and determine the free acid and total acid. 5. Blood was taken every 30 minutes, and blood glucose was measured once for 4 times. The result is judged: 3 or more of the following conditions are positive: 1. The acidity of free hydrochloric acid is 20mmol/L higher than that of basic gastric juice, or the lack of basic gastric acid. The acidity of free hydrochloric acid after injection of insulin is increased by ≥10mmol/L. For example, within 45 minutes after insulin injection, the above standard is early-positive, and 45-120 minutes is delayed. 2. The amount of gastric juice increases. 3. The amount of basal gastric acid secretion was 2 mmol/h. 4. Within 1 h, the total acid secretion was >2 mmol/h. 5. After the injection of insulin, there was an increase in early acid concentration within 1 h. Not suitable for the crowd Inappropriate people: older or suffering from cardiovascular disease, especially those with coronary heart disease who have contraindications for gastric tube. Adverse reactions and risks No special complications or hazards.