Kamada T, Hata J, Kusunoki H, Sugiu K, Ito M, Tanaka S, Kawamura Y, Chayama K, Haruma K
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Matsushima, Kurashiki, Japan.
Aliment Pharmacol Ther. 2005 Jun;21 Suppl 2:99-104. doi: 10.1111/j.1365-2036.2005.02482.x.
Recent studies showed that acid-suppressive therapy aggravates corpus gastritis in patients with Helicobacter pylori infection.
The aim of this study was to evaluate the effect of famotidine, a histamine receptor antagonist on corpus gastritis in patients with peptic ulcer disease.
We enrolled 287 patients, 173 with duodenal ulcer and 114 with gastric ulcer and 100 patients with H. pylori-positive gastritis as control subjects. Patients with peptic ulcer were classified according to whether or not they received famotidine-maintenance therapy (20 mg/day) after primary treatment. At the time of endoscopy, biopsy specimens were obtained from the antrum and the corpus. The degrees of neutrophil and lymphocyte infiltration, atrophy and intestinal metaplasia were scored according to the updated Sydney System.
The degrees of neutrophil infiltration and atrophy in the corpus were significantly less in patients with gastric ulcer or duodenal ulcer than in patients with H. pylori-positive gastritis (P < 0.01). Differences in the degrees of neutrophil infiltration and atrophy in the corpus between the non-maintenance group and the maintenance group were not significant.
Long-term therapy with famotidine does not appear to lead to an increase in the incidence of corpus gastritis or corpus atrophy in patients with peptic ulcer disease.
近期研究表明，抑酸治疗会加重幽门螺杆菌感染患者的胃体胃炎。
本研究旨在评估组胺受体拮抗剂法莫替丁对消化性溃疡病患者胃体胃炎的影响。
我们纳入了287例患者，其中173例为十二指肠溃疡患者，114例为胃溃疡患者，另有100例幽门螺杆菌阳性胃炎患者作为对照。消化性溃疡患者根据初次治疗后是否接受法莫替丁维持治疗（20毫克/天）进行分类。在内镜检查时，从胃窦和胃体获取活检标本。根据更新的悉尼系统对中性粒细胞和淋巴细胞浸润、萎缩及肠化生程度进行评分。
胃溃疡或十二指肠溃疡患者胃体中的中性粒细胞浸润和萎缩程度显著低于幽门螺杆菌阳性胃炎患者（P < 0.01）。非维持治疗组和维持治疗组胃体中中性粒细胞浸润和萎缩程度的差异不显著。
法莫替丁长期治疗似乎不会导致消化性溃疡病患者胃体胃炎或胃体萎缩发生率增加。
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