Sumii K, Inbe A, Uemura N, Kimura M, Haruma K, Yoshihara M, Teshima H, Kajiyama G, Miyoshi A
First Dept. of Internal Medicine, Hiroshima University School of Medicine, Japan.
Scand J Gastroenterol. 1989 Dec;24(10):1200-4. doi: 10.3109/00365528909090787.
To determine whether the serum pepsinogen I (PG I) level would be a suitable marker for selecting patients at risk for duodenal ulcer recurrence and, thus, would benefit from maintenance therapy, we treated duodenal ulcer patients with H2-receptor antagonists. After healing 140 ulcer patients we assessed the recurrence rate at 1 year with and without maintenance therapy. The annual recurrence rates in duodenal ulcer patients with hyper-PGI (95 ng/ml or more), with 66 ng/ml less than or equal to PGI less than 95 ng/ml, and with PGI less than 66 ng/ml were 87.0%, 27.3%, and 17.9%, respectively, when they did not receive maintenance therapy. In patients with hyper-PGI the recurrence rate was significantly lower in patients receiving maintenance therapy than in patients not receiving maintenance therapy, whereas in patients with PGI less than 66 ng/ml the recurrence rate was as low as 20% regardless of maintenance therapy. These results indicate that maintenance therapy with half the dose of H2-receptor antagonist is not required by patients with PGI less than 66 ng/ml, whereas those with hyper-PGI may be good candidates for long-term maintenance therapy.
为了确定血清胃蛋白酶原I（PG I）水平是否会成为筛选十二指肠溃疡复发风险患者的合适标志物，从而使这些患者能够从维持治疗中获益，我们用H2受体拮抗剂治疗十二指肠溃疡患者。在治愈140例溃疡患者后，我们评估了有无维持治疗情况下1年时的复发率。未接受维持治疗时，PG I水平高（95 ng/ml或更高）、66 ng/ml≤PG I＜95 ng/ml以及PG I＜66 ng/ml的十二指肠溃疡患者的年复发率分别为87.0%、27.3%和17.9%。PG I水平高的患者中，接受维持治疗的患者复发率显著低于未接受维持治疗的患者，而PG I＜66 ng/ml的患者无论是否接受维持治疗，复发率都低至20%。这些结果表明，PG I＜66 ng/ml的患者不需要用半量H2受体拮抗剂进行维持治疗，而PG I水平高的患者可能是长期维持治疗的合适人选。
