Abuduwaili Maidina, Boda Tomoyuki, Ito Masanori, Takigawa Hidehiko, Kotachi Takahiro, Matsuo Taiji, Oka Shiro, Tanaka Shinji
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan.
Gastroenterol Res Pract. 2022 Jan 28;2022:2830227. doi: 10.1155/2022/2830227. eCollection 2022.
Acid secretion inhibitors, such as proton pump inhibitors (PPIs) and potassium competitive acid blockers (PCABs), are used to treat ulcers after endoscopic submucosal dissection (ESD) for early gastric cancer. These drugs can influence serum gastrin and pepsinogen (PG) levels; however, their definite effects remain unclear. This open-label, randomized study investigated the effect of acid secretion inhibitors on the serum gastrin and pepsinogen levels. In total, 76 patients were enrolled in the study. They underwent gastric ESD and received a PPI ( = 21) or PCAB ( = 55). Changes in the serum gastrin and PG levels before and 4 weeks after administration were examined. Patient factors associated with the alteration of serum PG or gastrin levels were identified. The median serum levels of gastrin, PGI, and PGII before the administration of the acid secretion inhibitors were 110.5 pg/mL, 36.4 ng/mL, and 8.9 ng/mL, respectively; after administration, the levels increased to 300 pg/mL, 64.7 ng/mL, and 15.8 ng/mL, respectively ( < 0.01). Univariate analysis revealed that PCABs led to a more significant increase in the serum gastrin and PG levels as compared to PPIs. Furthermore, the PG levels were significantly increased in patients with previous infections than in those with current infections. In conclusion, the serum gastrin and PG levels increased after the use of acid secretion inhibitors. This elevation was affected by the type of drug used, whereas the elevation in PGs was affected by the patient's background as well.
酸分泌抑制剂，如质子泵抑制剂（PPIs）和钾竞争性酸阻滞剂（PCABs），用于治疗早期胃癌内镜下黏膜下剥离术（ESD）后的溃疡。这些药物会影响血清胃泌素和胃蛋白酶原（PG）水平；然而，它们的确切作用仍不清楚。这项开放标签的随机研究调查了酸分泌抑制剂对血清胃泌素和胃蛋白酶原水平的影响。共有76例患者纳入该研究。他们接受了胃ESD，并接受了PPI（n = 21）或PCAB（n = 55）治疗。检测给药前和给药后4周血清胃泌素和PG水平的变化。确定与血清PG或胃泌素水平改变相关的患者因素。酸分泌抑制剂给药前胃泌素、PGI和PGII的血清中位水平分别为110.5 pg/mL、36.4 ng/mL和8.9 ng/mL；给药后，这些水平分别升至300 pg/mL、64.7 ng/mL和15.8 ng/mL（P < 0.01）。单因素分析显示，与PPIs相比，PCABs导致血清胃泌素和PG水平升高更为显著。此外，既往感染患者的PG水平较现感染患者显著升高。总之，使用酸分泌抑制剂后血清胃泌素和PG水平升高。这种升高受所用药物类型的影响，而PGs的升高也受患者背景的影响。
