Lee F I, Isaacs P E
Department of Gastroenterology, Victoria Hospital, Blackpool, Lancashire, England.
Am J Gastroenterol. 1988 Sep;83(9):914-6.
Between January 1984 and December 1986, 116 patients were found to have columnar-lined esophagus (Barrett's esophagus) during upper gastrointestinal endoscopy. Twenty-eight patients (16 men and 12 women) were found to have peptic ulcer of the esophagus (Barrett's ulcer). In 17 (60%), standard measures and ranitidine 300 mg daily resulted in healing. Two men with resistant ulcers were treated by surgical repair of their hiatus hernia. Nine (six men, three women) in whom healing failed to occur on this regimen after 3-15 months were treated with high dose ranitidine (300 mg bd). In five, healing was complete after 8 wk and one more healed after an additional 4 wk. The three patients with unhealed ulcers after high dose ranitidine received omeprazole 40 mg in the morning. In two of these, ulcers healed after 4 wk; in the third, one of two ulcers persisted after 8 wk, although the remaining ulcer was smaller and more superficial. Pain relief was good, but minor reflux symptoms persisted in both treatment groups. On completion of the study, patients received 300 mg ranitidine at night. Powerful acid-reducing regimens may be required to heal a proportion of Barrett's ulcers.
1984年1月至1986年12月期间，116例患者在上消化道内镜检查时被发现有柱状上皮化生食管（巴雷特食管）。28例患者（16例男性和12例女性）被发现有食管消化性溃疡（巴雷特溃疡）。17例（60%）患者采用标准措施并每日服用300毫克雷尼替丁后溃疡愈合。2例顽固性溃疡男性患者接受了食管裂孔疝手术修补治疗。9例（6例男性，3例女性）患者在采用该治疗方案3至15个月后溃疡仍未愈合，随后接受了高剂量雷尼替丁（每日两次，每次300毫克）治疗。其中5例患者在8周后溃疡完全愈合，另有1例在额外4周后愈合。3例高剂量雷尼替丁治疗后溃疡未愈合的患者在早晨服用40毫克奥美拉唑。其中2例患者在4周后溃疡愈合；第3例患者在8周后，两个溃疡中有一个仍未愈合，尽管另一个溃疡变小且变浅。疼痛缓解情况良好，但两个治疗组均仍有轻微的反流症状。研究结束时，患者在夜间服用300毫克雷尼替丁。治愈一部分巴雷特溃疡可能需要强效的抑酸方案。
