Hewson E G, Yeomans N D, Angus P W, Shulkes A, Brook C W, Sewell R B, Smallwood R A
University of Melbourne Department of Medicine, (Gastroenterology), Victoria, Australia.
Gut. 1988 Dec;29(12):1715-20. doi: 10.1136/gut.29.12.1715.
The effect of intermittent dosage with omeprazole on basal and pentagastrin stimulated gastric acid secretion and fasting plasma gastrin was assessed in eight duodenal ulcer subjects who were in remission. Omeprazole (20 mg daily) was given for a three day 'weekend' each week for two months. Twenty four hours after the first and eighth weekend, basal and peak acid output were still markedly suppressed (greater than 50%) compared with pretreatment. After the treatment free four days, however (just before the eighth weekend), peak acid output had returned to pretreatment values; basal acid output was still somewhat reduced (mean 3.6 mmol/l) but the difference from baseline was not statistically significant. Fasting plasma gastrin concentration increased slightly but significantly, from a baseline median of 17 pmol/l to 25 and 31 pmol/l respectively, 24 hours after the first and eighth weekends. All but two values (of 16) remained within the reference range. Before the fourth and eighth weekends, and again at 12 days and three months after treatment, gastrin values were not significantly different from baseline. Thus a 'weekend therapy' regimen with this long acting antisecretory compound produces substantial acid suppression, but for only part of the week, with modest and reversible changes in fasting plasma gastrin. It should therefore be suitable for efficacy testing for prevention of recurrence of peptic ulcer or reflux oesophagitis.
在八名处于缓解期的十二指肠溃疡患者中，评估了间歇性服用奥美拉唑对基础胃酸分泌、五肽胃泌素刺激的胃酸分泌以及空腹血浆胃泌素的影响。每周的“周末”给予奥美拉唑（每日20毫克），持续两个月。在第一个和第八个周末后的24小时，与治疗前相比，基础胃酸分泌量和胃酸分泌峰值仍受到显著抑制（超过50%）。然而，在停药的四天后（恰好在第八个周末之前），胃酸分泌峰值已恢复到治疗前水平；基础胃酸分泌量仍有所降低（平均为3.6毫摩尔/升），但与基线的差异无统计学意义。空腹血浆胃泌素浓度略有升高但具有统计学意义，在第一个和第八个周末后的24小时，分别从基线中位数17皮摩尔/升升至25皮摩尔/升和31皮摩尔/升。16个值中除两个外均保持在参考范围内。在第四个和第八个周末之前，以及治疗后12天和三个月时，胃泌素值与基线无显著差异。因此，这种长效抗分泌化合物的“周末疗法”方案可产生显著的胃酸抑制作用，但仅在一周中的部分时间有效，空腹血浆胃泌素仅有适度且可逆的变化。所以它应该适用于消化性溃疡或反流性食管炎复发预防的疗效测试。
