Koop H, Arnold R, Classen M, Fischer M, Goebell H, Blum A L
Department of Medicine, Philipps-University, Marburg, Germany.
J Clin Gastroenterol. 1992 Dec;15(4):291-5. doi: 10.1097/00004836-199212000-00005.
A total of 2,109 outpatients with active duodenal ulcer (DU) entered an open, prospective study in order to investigate factors influencing healing and relapse during 2 years of ranitidine therapy (300 mg daily for healing, 150 mg as maintenance treatment). In a retrospective analysis, we evaluated the influence of age. Symptoms related to DU in 1,899 evaluable cases in patients over 65 years of age (n = 185) were identical to those of DU patients younger than 65 years old (n = 1,714). Rapid healing within 2 weeks of ranitidine therapy was less frequent in the elderly (32.5%) than in younger patients (40.7%) though identical healing rates (94.1%) in each group were achieved by continuation of ranitidine therapy for 8 weeks. Cumulative recurrence rates during the 2 years of long-term therapy were lower (17.3%) in old age than in patients under 65 years of age (23.3%). Adverse events were rare in both age groups. We conclude that DU healing during ranitidine is delayed in old age. Additional differences in relapse rates in favor of the elderly suggest that DU disease has a different course in the elderly.
共有2109例活动性十二指肠溃疡(DU)门诊患者进入一项开放性前瞻性研究,以调查雷尼替丁治疗2年期间影响愈合和复发的因素(愈合期每日300mg,维持治疗每日150mg)。在一项回顾性分析中,我们评估了年龄的影响。在1899例可评估病例中,65岁以上患者(n = 185)与DU相关的症状与65岁以下DU患者(n = 1714)相同。雷尼替丁治疗2周内快速愈合在老年患者中(32.5%)比年轻患者(40.7%)少见,不过通过继续雷尼替丁治疗8周,两组的愈合率相同(94.1%)。长期治疗2年期间的累积复发率在老年患者中较低(17.3%),低于65岁以下患者(23.3%)。两个年龄组的不良事件均少见。我们得出结论,雷尼替丁治疗期间DU愈合在老年患者中延迟。有利于老年患者的复发率的其他差异表明,DU疾病在老年患者中有不同病程。