Wilson D E
Am J Med. 1987 Jul 27;83(1A):2-8. doi: 10.1016/0002-9343(87)90571-7.
Misoprostol, a synthetic methyl ester analogue of prostaglandin E1, inhibits basal, nocturnal, and stimulated gastric acid secretion. In doses of 400 to 1,200 micrograms daily, misoprostol accelerates the healing of duodenal and gastric ulcers in humans. In addition to its antisecretory actions, misoprostol has gastroduodenal mucosal protective (cytoprotective) effects in animals and in humans. In humans, these cytoprotective actions have been demonstrated in acid-dependent studies using non-antisecretory doses and in acid-independent studies using antisecretory doses. Patients with peptic ulcer disease may have a relative deficiency of mucosal prostaglandin synthesis as compared with nonulcer control subjects. In addition, patients who consume nonsteroidal anti-inflammatory drugs and those who are cigarette smokers may also have depressed gastric mucosal prostaglandin synthesis. There is some evidence that misoprostol reverses the deleterious effect of smoking on duodenal ulcer healing and that it is effective in treating and preventing mucosal damage induced by nonsteroidal anti-inflammatory drugs and alcohol.
米索前列醇是一种前列腺素E1的合成甲酯类似物，可抑制基础胃酸分泌、夜间胃酸分泌以及刺激后的胃酸分泌。每日服用400至1200微克剂量的米索前列醇可加速人类十二指肠溃疡和胃溃疡的愈合。除了其抗分泌作用外，米索前列醇在动物和人类中均具有胃十二指肠黏膜保护（细胞保护）作用。在人类中，这些细胞保护作用已在使用非抗分泌剂量的酸依赖性研究以及使用抗分泌剂量的酸非依赖性研究中得到证实。与无溃疡的对照受试者相比，消化性溃疡病患者的黏膜前列腺素合成可能相对不足。此外，服用非甾体抗炎药的患者以及吸烟者的胃黏膜前列腺素合成也可能受到抑制。有证据表明，米索前列醇可逆转吸烟对十二指肠溃疡愈合的有害影响，并且它在治疗和预防非甾体抗炎药和酒精引起的黏膜损伤方面有效。
