Takahashi Kazuya, Sato Yuichi, Kohisa Junji, Watanabe Jun, Sato Hiroki, Mizuno Kenichi, Hashimoto Satoru, Terai Shuji
Kazuya Takahashi, Yuichi Sato, Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan.
World J Gastrointest Endosc. 2016 Nov 16;8(19):716-722. doi: 10.4253/wjge.v8.i19.716.
To compare the healing effects of vonoprazan and lansoprazole on gastric ulcers induced by endoscopic submucosal dissection (ESD).
Data were obtained from a total of 26 patients. Fourteen patients were randomized to the vonoprazan group and 12 were randomized to the lansoprazole group. Patients were administered either 20 mg vonoprazan or 30 mg lansoprazole per day after ESD. Endoscopic images just after ESD, on day 8, and on day 28 were used for the evaluation of the shrinking rate of ESD ulcers. The shrinking rates and the incidence of delayed bleeding were compared between the 2 groups.
The shrinking rates of ESD ulcers on day 8 [vonoprazan group: 61.8% (range: 24.0%-91.1%), lansoprazole group: 71.3% (range: 25.2%-88.6%)] and on day 28 [vonoprazan group: 95.3% (range: 76.2%-100%), lansoprazole group: 97.2% (range: 81.1%-99.8%)] were not statistically different between the 2 groups. On day 28, most of the ulcers in both groups healed to more than 90%, whereas 3 of 14 (21.4%) in the vonoprazan group and 1 of 12 (8.3%) in the lansoprazole group had delayed ulcer healing, which was not statistically different ( = 0.356). The frequency of delayed bleeding was 0 in the both groups. Taken together, there were no significant differences between the two drug groups.
Our study indicates that vonoprazan is potent for the management of ESD ulcers although lansoprazole is also sufficient and cost-effective.
比较沃克和兰索拉唑对内镜黏膜下剥离术（ESD）所致胃溃疡的愈合效果。
共纳入26例患者的数据。14例患者随机分为沃克组，12例患者随机分为兰索拉唑组。ESD术后，患者每天分别服用20 mg沃克或30 mg兰索拉唑。ESD术后即刻、第8天和第28天的内镜图像用于评估ESD溃疡的缩小率。比较两组的缩小率和延迟出血发生率。
第8天[沃克组：61.8%（范围：24.0%-91.1%），兰索拉唑组：71.3%（范围：25.2%-88.6%）]和第28天[沃克组：95.3%（范围：76.2%-100%），兰索拉唑组：97.2%（范围：81.1%-99.8%）]时，两组ESD溃疡的缩小率无统计学差异。第28天，两组大多数溃疡愈合率均超过90%，而沃克组14例中有3例（21.4%）、兰索拉唑组12例中有1例（8.3%）出现溃疡愈合延迟，差异无统计学意义（P = 0.356）。两组延迟出血的发生率均为0。综上所述，两个药物组之间无显著差异。
我们的研究表明，尽管兰索拉唑也足够且具有成本效益，但沃克在治疗ESD溃疡方面效果显著。
