Martínez R O, Casas H, Mazure P A, Leczycki H, Cosen J N, Canievsky L, Abib A
Servicio de Gastroenterología, Hospital Profesor A. Posadas, Haedo, Buenos Aires.
Acta Gastroenterol Latinoam. 1988;18(2):87-96.
In a group of 70 patients of both sexes been treated with antiinflammatory drugs, affected by Rheumatoid Arthritis in activity, we have found the presence of lesions, erosions and gastroduodenal ulcers in 40% by endoscopic examination (26% erosions and 14% ulcers), without any relation with clinical symptoms. Those patients who received larger doses than 30mgr./kg./day of AAS suffered most frequently lesions (43.8%). These 28 patients with lesions have been studied prospectively in a double blind method, and treated twice a day with 150 mgs. doses of Ranitidine or Placebo, throughout a period of 5 weeks without discontinuing the treatment with anti-inflammatories (AAS, Indomethacin, steroids). At the end of the trial those patients who failed in healing their lesions were treated with Ranitidine in the same doses for another period of 5 weeks. The treatment with Ranitidine in doses of 300 mgr/day has resulted curative of the gastroduodenal lesions, although maintaining the aggressive drugs, in the 87% of the patients. We have observed that the treatment with Placebo is less effective and that difference has high statistical significance (p 0.005).
在一组70名患有活动性类风湿关节炎且正在接受抗炎药物治疗的男女患者中，通过内镜检查我们发现40%的患者存在病变、糜烂和胃十二指肠溃疡（26%为糜烂，14%为溃疡），且与临床症状无任何关联。那些接受高于30毫克/千克/天剂量的非甾体抗炎药（AAS）的患者最常出现病变（43.8%）。对这28名有病变的患者采用双盲法进行前瞻性研究，在持续5周且不中断抗炎药（AAS、吲哚美辛、类固醇）治疗的情况下，每天两次给予150毫克剂量的雷尼替丁或安慰剂。试验结束时，那些病变未愈合的患者再以相同剂量的雷尼替丁治疗5周。尽管继续使用强效药物，但每天300毫克剂量的雷尼替丁治疗使87%的患者的胃十二指肠病变得以治愈。我们观察到安慰剂治疗效果较差，且这种差异具有高度统计学意义（p < 0.005）。
