Collen M J, Howard J M, McArthur K E, Raufman J P, Cornelius M J, Ciarleglio C A, Gardner J D, Jensen R T
Ann Intern Med. 1984 Jan;100(1):52-8. doi: 10.7326/0003-4819-100-1-52.
The H2-histamine receptor antagonists, cimetidine and ranitidine, were compared for their abilities to control acid secretion on a short- and long-term basis in 13 patients with gastric hypersecretory disorders. The rate of onset of action did not differ between the two drugs. The actions of both drugs were increased by an anticholinergic agent, and there was a close correlation between the daily maintenance dose of each drug needed to control acid secretion. However, ranitidine was threefold more potent than cimetidine and no male patient developed breast changes or impotence while taking ranitidine. Treatment with high doses of ranitidine for 6 to 25 months was not associated with hepatic or hematologic toxicity or alterations of serum gastrin levels, but was associated with a significantly lower serum creatinine level than that seen with cimetidine therapy. These studies show that ranitidine can adequately inhibit acid secretion in patients with gastric hypersecretory disorders, is safe at high doses, does not cause the antiandrogen side effects frequently seen with high doses of cimetidine, and is threefold more potent than cimetidine. Patients who are relatively resistant to cimetidine will have proportional resistance to ranitidine.
对13例胃酸分泌过多症患者，比较了H2组胺受体拮抗剂西咪替丁和雷尼替丁在短期和长期控制胃酸分泌方面的能力。两种药物的起效速度没有差异。抗胆碱能药物可增强两种药物的作用，且控制胃酸分泌所需的每种药物的每日维持剂量之间存在密切相关性。然而，雷尼替丁的效力是西咪替丁的三倍，服用雷尼替丁时没有男性患者出现乳房变化或阳痿。高剂量雷尼替丁治疗6至25个月与肝毒性、血液学毒性或血清胃泌素水平改变无关，但与血清肌酐水平显著低于西咪替丁治疗时的情况有关。这些研究表明，雷尼替丁可充分抑制胃酸分泌过多症患者的胃酸分泌，高剂量时安全，不会引起高剂量西咪替丁常见的抗雄激素副作用，且效力是西咪替丁的三倍。对西咪替丁相对耐药的患者对雷尼替丁也会有相应的耐药性。
