Doherty C C, O'Connor F A, Buchanan K D, McGeown M G
Br Med J. 1977 Dec 10;2(6101):1506-8. doi: 10.1136/bmj.2.6101.1506.
Peptic ulcer is a common problem in advanced renal failure, but most drugs for ulcers are hazardous in this condition. In a small open study cimetidine was given to nine patients with acid hypersecretion and endoscopically diagnosed duodenal ulceration who were undergoing haemodialysis. The patients obtained good pain relief and suffered no serious side effects. Both basal and stimulated acid output fell considerably and the plasma gastrin response to food increased during treatment. Two patients with recurrent vomiting during haemodialysis had a striking response to cimetidine, which suggested that such vomiting may be acid-mediated in some patients. These preliminary results suggest that cimetidine may prove to be an advance in the management of peptic ulcer in uraemic patients.
消化性溃疡是晚期肾衰竭中的常见问题,但大多数治疗溃疡的药物在这种情况下都有风险。在一项小型开放性研究中,对9名正在接受血液透析、伴有胃酸分泌过多且经内镜诊断为十二指肠溃疡的患者给予了西咪替丁。患者疼痛得到了很好的缓解,且未出现严重副作用。治疗期间,基础胃酸分泌量和刺激胃酸分泌量均大幅下降,血浆胃泌素对食物的反应增强。两名在血液透析期间反复呕吐的患者对西咪替丁有显著反应,这表明在某些患者中,这种呕吐可能是由酸介导的。这些初步结果表明,西咪替丁可能会被证明是尿毒症患者消化性溃疡治疗方面的一项进展。