Lam S K
Clin Invest Med. 1987 May;10(3):232-7.
Studies to date indicate that certain synthetic prostaglandin E derivatives, notably misoprostol and enprostil, possess duodenal ulcer healing efficacy that is equivalent to that of the existing H2-receptor antagonists. Whether healing is achieved by virtue of their antisecretory action alone or in combination with their cytoprotective properties cannot be ascertained. Earlier reports that non-antisecretory prostaglandin E2 was effective for duodenal-ulcer healing suggested that cytoprotective mechanisms may contribute to ulcer healing, but this needs be confirmed. Chronic cigarette smoking adversely affects duodenal ulcer healing despite treatment with potent acid-reducing regimens. Evidence is available that cigarette smoking reduces luminal prostaglandins in the stomach, and that misoprostol, a prostaglandin E1 is able to overcome the adverse effect of smoking on duodenal ulcer healing, further suggesting that cytoprotective mechanisms may contribute to ulcer healing. Furthermore, misoprostol has been shown to be the first therapeutic agent capable of improving active chronic antral gastritis, which has recently been found to be almost invariably associated with active duodenal ulcer.
迄今为止的研究表明，某些合成前列腺素E衍生物，尤其是米索前列醇和恩前列素，具有与现有H2受体拮抗剂相当的十二指肠溃疡愈合疗效。目前尚无法确定溃疡愈合是仅凭借其抗分泌作用，还是与细胞保护特性共同作用实现的。早期报道称非抗分泌性前列腺素E2对十二指肠溃疡愈合有效，这表明细胞保护机制可能有助于溃疡愈合，但这一点仍需证实。尽管采用了强效的抑酸治疗方案，长期吸烟仍会对十二指肠溃疡的愈合产生不利影响。有证据表明，吸烟会降低胃内的前列腺素水平，而前列腺素E1类似物米索前列醇能够克服吸烟对十二指肠溃疡愈合的不利影响，这进一步表明细胞保护机制可能有助于溃疡愈合。此外，米索前列醇已被证明是第一种能够改善活动性慢性胃窦炎的治疗药物，而最近发现活动性慢性胃窦炎几乎总是与活动性十二指肠溃疡相关。
