Mahachai V, Walker K, Thomson A B, Zuk L, Kirdeikis P, Fisher D, Brunet K
Dig Dis Sci. 1985 Apr;30(4):321-8. doi: 10.1007/BF01403840.
Twenty-four-hour intragastric pH and serum gastrin profiles were monitored in six male asymptomatic patients who previously were found to have esophagitis on endoscopy and biopsy. They received cimetidine 300 mg qid (C), ranitidine 150 mg bid (R), or placebo (P) for one week each, utilizing the Latin-square design. The mean BAO was 0.4 +/- 0.2 mmol/hr, and the pentagastrin-stimulated MAO was 21.2 +/- 3.2 mmol/hr. In the P-treated patients, the pH fluctuated between 1.8 and 3.5 and over 90% of the readings were less than pH 4. As compared to P, both C and R significantly suppressed H+ after breakfast, overnight, and over the 24-hr period. The mean pH after lunch was significantly higher in R than in P, but not in C. Over the 24-hr period, a higher percentage of the readings were above pH 4.0 in R as compared to C. During the night, 50% of the pH readings were above pH 4.0 in C and R, whereas in P 50% of the pH readings were less than pH 2.0. The integrated gastrin responses after each meal were similar in C and R and were greater than in P. The biphasic response of the ratio of H+ and gastrin (H+/G) following each meal was suppressed by both H2-receptor antagonists, with numerically lower values obtained in R than in C. This study suggests that ranitidine 150 mg bid is superior to cimetidine 300 mg qid in suppressing the 24-hr intragastric acidity.
对6名男性无症状患者进行了24小时胃内pH值和血清胃泌素监测，这些患者先前经内镜检查和活检发现患有食管炎。他们采用拉丁方设计，分别接受西咪替丁300毫克每日4次（C组）、雷尼替丁150毫克每日2次（R组）或安慰剂（P组）治疗，每组治疗1周。平均基础胃酸分泌量（BAO）为0.4±0.2毫摩尔/小时，五肽胃泌素刺激的最大胃酸分泌量（MAO）为21.2±3.2毫摩尔/小时。在接受安慰剂治疗的患者中，pH值在1.8至3.5之间波动，超过90%的读数低于pH 4。与安慰剂相比，西咪替丁和雷尼替丁在早餐后、夜间以及24小时期间均能显著抑制氢离子分泌。午餐后的平均pH值，雷尼替丁组显著高于安慰剂组，但西咪替丁组与安慰剂组无显著差异。在24小时期间，雷尼替丁组高于pH 4.0的读数百分比高于西咪替丁组。夜间，西咪替丁组和雷尼替丁组50%的pH读数高于pH 4.0，而安慰剂组50%的pH读数低于pH 2.0。每餐餐后胃泌素的综合反应在西咪替丁组和雷尼替丁组相似，且均大于安慰剂组。两种H2受体拮抗剂均抑制了每餐餐后氢离子与胃泌素比值（H+/G）的双相反应，雷尼替丁组的数值低于西咪替丁组。本研究表明，雷尼替丁150毫克每日2次在抑制24小时胃内酸度方面优于西咪替丁300毫克每日4次。
