长期抑酸维持治疗预防十二指肠溃疡复发的疗效及对血胃泌素的影响

Effects of long-term maintenance therapy on the prevention of recurrent duodenal ulcer and the level of serum gastrin

目的 研究兰索拉唑治疗十二指肠溃疡和维持治疗预防溃疡复发的疗效 ,并探讨各疗程血清胃泌素水平的变化。方法 经胃镜证实的活动期十二指肠溃疡患者 90例 ,给予兰索拉唑 30mg ,qd× 4周 ,将溃疡愈合达瘢痕期的 6 7例患者随机分为两个治疗组。A组 :兰索拉唑 15mg ,qd ,维持 3个月 ;B组 :兰索拉唑 15mg ,qd ,维持 6个月。在治疗前 ,治疗 4周 ,维持治疗 3、6、9个月末分别复查胃镜 ,并检测血清胃泌素水平的变化。结果 治疗 4周后 ,溃疡愈合率 94 .4 % ( 85 / 90 )。A组和B组患者的溃疡半年累积复发率分别为 17.6 % ( 6 / 34)和 18.1% ( 6 / 33) ,2组间差异无显著性。在治疗 4周时 ,血清胃泌素水平基本达到一稳定水平 ,在维持治疗阶段无进一步升高 ,停药后 3个月基本恢复到基础水平。结论 3个月或 6个月低剂量兰索拉唑维持治疗可有效预防十二指肠溃疡复发 。

Objective To evaluate the effect of takeprin in preventing the recurrence of duodenal ulcer (DU) and investigate the varying level of serum gastrin. Methods 67 patients with DU, who had been treated with takeprin 30 mg qd for 4 weeks and had reached scar stage, were divided into two groups: in group A, the patients were maintained with takeprin 15 mg qd for 3 months, while in group B, the maintenance therapy was prolonged to 6 months. Gastroscopy was performed and serum gastrin was assayed before and after the 4-week treatment and 3, 6 and 9 months after the maintenance therapy. Results Ulcer healing rate was 94.4%(85/90) after the 4-week takeprin treatment. The semi-annual cumulative recurrence rate of DU was 17.6% (6/34) and 18.1% (6/33) in group A and group B respectively(P>0.05). The serum gastrin attained a relatively stable level after the 4-week treatment and was not further elevated in the course of maintenance therapy, and the serum gastrin returned to its basal level 3 months after the therapy was stopped. Conclusion Maintenance therapy of lower-dose takeprin for 3 or 6 months is effective for the prevention of recurrent DU, without causing further ascension of serum gastrin.