Lee C T, Kuo B I, Chen C Y, Chang F Y, Lee S D
Department of Medicine, Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China.
Eur J Clin Pharmacol. 1999 Jan;54(11):817-20. doi: 10.1007/s002280050559.
To determine which demographic factors may influence serum gastrin and pepsinogen I (PGI) levels in duodenal ulcer patients undergoing omeprazole treatment.
We conducted an outpatient-based prospective study in the Veterans General Hospital, Taipei, to investigate the pharmacological effects on patients with duodenal ulcers receiving omeprazole treatment for 4 weeks. Sixty-eight patients (61 males/7 females, aged 25 73 years) with endoscopically confirmed duodenal ulcer were included. Gastrin and pepsinogen I levels were measured before and after treatment. Demographic factors including age, sex, smoking, ulcer healing and antral Helicobacter pylori colonization/clearance were analyzed, in order to measure their probable influences on serum gastrin and pepsinogen I levels.
Ulcer healing was seen in 92.6% of patients while 48 (70.6%) antral clearances were seen in 66 H. pylori colonized patients at the end of trial. Omeprazole monotherapy led to a marked elevation of serum gastrin (85.8 pg x ml(-1), SD 32.0 pg x ml(-1) vs 133.9 pg x ml(-1), SD 71.6 pg x ml(-1), P < 0.01), and pepsinogen I (111.0 ng x ml(-1), SD 36.7 ng x ml(-1) vs 253.6 ng x ml(-1) , SD 64.8 ng x ml(-1), P < 0.01) levels when measured on day 29. Only patients showing antral H. pylori clearance exhibited an influence on the magnitude of pepsinogen I elevation following omeprazole monotherapy (143.9%, SD 67.3% vs 78.6%, SD 51.2%, P < 0.01). Moreover, the sensitivity and specificity of serum pepsinogen I variations were plotted on a receiving operating characteristic (ROC) curve. The 140% increased pepsinogen I level yielded a maximum accuracy of 80% specificity or 50% sensitivity to predict antral H. pylori clearance.
Antral H. pylori clearance is at least partially responsible for the omeprzaole-induced hyperpepsinogenemia I. The magnitude of hyperpepsinogenemia I probably provides a non-invasive alternative for predicting H. pylori clearance.
确定哪些人口统计学因素可能影响接受奥美拉唑治疗的十二指肠溃疡患者的血清胃泌素和胃蛋白酶原I（PGI）水平。
我们在台北荣民总医院进行了一项基于门诊的前瞻性研究，以调查奥美拉唑治疗4周对十二指肠溃疡患者的药理作用。纳入68例经内镜确诊为十二指肠溃疡的患者（61例男性/7例女性，年龄25 - 73岁）。在治疗前后测量胃泌素和胃蛋白酶原I水平。分析包括年龄、性别、吸烟、溃疡愈合及胃窦幽门螺杆菌定植/清除等人口统计学因素，以衡量它们对血清胃泌素和胃蛋白酶原I水平的可能影响。
92.6%的患者溃疡愈合，66例幽门螺杆菌定植患者在试验结束时48例（70.6%）胃窦清除。奥美拉唑单药治疗导致血清胃泌素显著升高（85.8 pg/ml，标准差32.0 pg/ml vs 133.9 pg/ml，标准差71.6 pg/ml，P < 0.01），以及胃蛋白酶原I（111.0 ng/ml，标准差36.7 ng/ml vs 253.6 ng/ml，标准差64.8 ng/ml，P < 0.01）水平在第29天测量时升高。仅显示胃窦幽门螺杆菌清除的患者对奥美拉唑单药治疗后胃蛋白酶原I升高幅度有影响（143.9%，标准差67.3% vs 78.6%，标准差51.2%，P < 0.01）。此外，血清胃蛋白酶原I变化的敏感性和特异性绘制在接受者操作特征（ROC）曲线上。胃蛋白酶原I水平升高140%对预测胃窦幽门螺杆菌清除的最大准确率为特异性80%或敏感性50%。
胃窦幽门螺杆菌清除至少部分导致了奥美拉唑诱导的高胃蛋白酶原血症I。高胃蛋白酶原血症I的幅度可能为预测幽门螺杆菌清除提供一种非侵入性替代方法。
