Inaba Tomoki, Ishikawa Shigenao, Toyokawa Tatsuya, Ishikawa Hisashi, Miyahara Koji, Wato Masaki, Kawai Kozo, Okada Hiroyuki, Yamamoto Kazuhide
Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan.
Hepatogastroenterology. 2010 May-Jun;57(99-100):678-84.
BACKGROUND/AIMS: When a peptic ulcer is treated with proton pump inhibitors (PPI), protrusion of the ulcer base is sometimes noted during ulcer healing. To clarify the incidence of ulcer base protrusion in ulcers induced by endoscopic submucosal dissection (ESD), and whether the addition of polaprezinc, a cytoprotective agent used for treatment of gastric ulcer, to the PPI regimen helps to suppress it.
One hundred sixty-three patients on which ESD was performed were randomly allocated to either two groups: one treated with lansoprazole (30mg/day) and the other with lansoprazole (30mg/day) plus polaprezinc (150mg/day) for the treatment of ESD-induced ulcer. The condition of the ESD-induced ulcer was blindly assessed two months after ESD by two physicians.
Lansoprazole plus polaprezinc group showed significantly better ulcer healing (p < 0.0001) and protrusion of the ulcer base was recognized in only 1.3% (1/77), an incidence significantly lower than that in lansoprazole group (20.7%, 16/77, p = 0.0001). Polaprezinc was the only significant factor (p = 0.0001) differentiating patients who had ulcer base protrusion (n = 17) from those who did not (n = 137).
Polaprezinc prevents protrusion of the ulcer base during the healing of ESD-induced ulcer with PPI.
背景/目的：当用质子泵抑制剂（PPI）治疗消化性溃疡时，在溃疡愈合过程中有时会注意到溃疡底部突出。为了明确内镜黏膜下剥离术（ESD）所致溃疡中溃疡底部突出的发生率，以及在PPI治疗方案中添加用于治疗胃溃疡的细胞保护剂聚普瑞锌是否有助于抑制这种情况。
对163例行ESD的患者随机分为两组：一组用兰索拉唑（30mg/天）治疗，另一组用兰索拉唑（30mg/天）加聚普瑞锌（150mg/天）治疗ESD所致溃疡。ESD术后两个月，由两名医生对ESD所致溃疡的情况进行盲法评估。
兰索拉唑加聚普瑞锌组溃疡愈合明显更好（p < 0.0001），仅1.3%（1/77）的患者出现溃疡底部突出，发生率显著低于兰索拉唑组（20.7%，16/77，p = 0.0001）。聚普瑞锌是区分有溃疡底部突出的患者（n = 17）和没有溃疡底部突出的患者（n = 137）的唯一显著因素（p = 0.0001）。
聚普瑞锌可预防PPI治疗ESD所致溃疡愈合过程中溃疡底部的突出。
