Solhaug J H, Carling L, Glise H, Hallerbäck B, Hallgren T, Kagevi I, Svedberg L E, Wählby L
Scand J Gastroenterol Suppl. 1987;127:77-80.
Ulcer relapses after short-term treatment of duodenal, prepyloric and gastric ulcers with Cimetidine 400 mg b.d. or Sucralfate 1 g q.i.d. were studied in 270 patients over one year. Endoscopic examinations were carried out 2-4 and 9-11 months after ulcer healing or when symptoms occurred. Ulcer relapses were found in 59% of the Cimetidine-treated patients and 51% of those treated with Sucralfate, and a further 21% and 16% respectively had endoscopically verified erosive gastroduodenitis. The cumulative recurrence rate in smokers was 82% and that in non-smokers 51% (p less than 0.001). Relapses among the Cimetidine patients occurred more often in those who smoked or had irregular working hours. The onset of the relapse was not related ulcer healing time. The ulcer relapses appeared in the same region as the initial ulcer in 88% of cases and exactly at the original site in 33%. These results suggest that cytoprotection by Sucralfate did not result in fewer or later relapses than acid reduction by Cimetidine. Cigarette smoking obviously increases the risk of relapse in patients with healed peptic ulcers.
对270例十二指肠溃疡、幽门管溃疡和胃溃疡患者进行了为期一年的研究，这些患者接受西咪替丁400毫克每日两次或硫糖铝1克每日四次的短期治疗后溃疡复发情况。在溃疡愈合后2 - 4个月和9 - 11个月或出现症状时进行内镜检查。西咪替丁治疗组溃疡复发率为59%，硫糖铝治疗组为51%，另外分别有21%和16%经内镜证实有糜烂性胃十二指肠炎症。吸烟者的累积复发率为82%，非吸烟者为51%（p < 0.001）。西咪替丁治疗的患者中，吸烟或工作时间不规律者复发更频繁。复发的开始与溃疡愈合时间无关。88%的病例溃疡复发出现在初始溃疡的同一区域，33%的病例复发恰好发生在原部位。这些结果表明，硫糖铝的细胞保护作用并不比西咪替丁的抑酸作用导致更少或更晚的复发。吸烟明显增加了消化性溃疡愈合患者的复发风险。
