西咪替丁低剂量维持治疗十二指肠溃疡：中期结果
Low dose maintenance treatment with cimetidine in duodenal ulcer: intermediate-term results.
作者信息
Bardhan K D, Hinchliffe R F, Bose K
出版信息
Postgrad Med J. 1986 May;62(727):347-51. doi: 10.1136/pgmj.62.727.347.
Ulcer relapse rates during up to 2 years of prophylactic low-dose maintenance therapy (LDMT) with cimetidine 400 mg at bedtime was examined in 261 patients. Endoscopy was repeated every 6 months if asymptomatic, or whenever symptoms recurred. Relapse was defined as the recurrence of an ulcer crater or erosions or both. In patients with non-refractory duodenal ulcer (those healed within 3 months) who comprise the majority, their likelihood of relapse at 6, 12, 18 and 24 months was: symptomatic 8%, 13%, 18%, 20%; silent 14%, 28%, 38%, 43%, respectively. In contrast, in patients with refractory ulcer, their symptomatic relapse rates were 36%, 45%, 46%, 48%, and silent 28%, 38%, 46%, 48% respectively. The outcome of a second course of LDMT was similar to the first. Narrowing the definition of relapse to exclude recurrence of erosions alone but without an ulcer decreased asymptomatic relapse in non-refractory ulcer patients by about half. No patient had any major side effects. Thus, LDMT is a safe and effective way of keeping most patients with duodenal ulcer symptom free over 2 years.
对261例患者进行了研究，观察睡前服用400毫克西咪替丁进行长达2年的预防性低剂量维持治疗（LDMT）期间的溃疡复发率。如果无症状，则每6个月重复进行一次内镜检查，或者在症状复发时随时进行检查。复发定义为溃疡 crater 或糜烂或两者同时复发。在大多数非难治性十二指肠溃疡患者（3个月内愈合者）中，他们在6、12、18和24个月时的复发可能性分别为：有症状者8%、13%、18%、20%；无症状者分别为14%、28%、38%、43%。相比之下，难治性溃疡患者的有症状复发率分别为36%、45%、46%、48%，无症状复发率分别为28%、38%、46%、48%。第二个疗程的LDMT结果与第一个疗程相似。将复发的定义缩小到仅排除单纯糜烂复发但无溃疡的情况后，非难治性溃疡患者的无症状复发率降低了约一半。没有患者出现任何严重副作用。因此，LDMT是使大多数十二指肠溃疡患者在2年内保持无症状的一种安全有效的方法。
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