Delpre G, Kadish U, Glanz I, Avidor I
Am J Gastroenterol. 1984 Jan;79(1):8-11.
In a 77-year-old man with dysphagia, x-rays demonstrated an irregular stenotic process in the lower third of the esophagus, suggesting malignancy. Endoscopy disclosed moderate narrowing of the lumen and several ulcers separated by bulges. Serial biopsies revealed Barrett's mucosa. Cimetidine 1 g/day led to prompt improvement and endoscopically there was a disappearance of the lesions after 3 months of therapy. Reduction of the drug to 400 mg/day 3 months later with supplements of antacids and metoclopramide was followed by reappearance of symptoms and recurrence of a deep ulcer. Raising the dose of cimetidine to 1 g/day again resulted in healing and since then a maintenance dose of 600 mg cimetidine with antacids and metoclopramide has been successful in preventing recurrence. This long-term study in a patient with Barrett's esophagus showed 1) that cimetidine can be effective in treating such patients; 2) the prophylactic value of multitherapy as a maintenance regimen, and 3) the importance of careful follow-up.
在一名77岁吞咽困难的男性患者中，X线显示食管下三分之一处有不规则狭窄病变，提示为恶性肿瘤。内镜检查发现管腔中度狭窄，有几个被隆起分隔的溃疡。系列活检显示为巴雷特黏膜。每天服用1克西咪替丁后症状迅速改善，治疗3个月后内镜检查发现病变消失。3个月后将药物剂量减至每天400毫克，并补充抗酸剂和甲氧氯普胺，随后症状再次出现，且出现了一个深溃疡。再次将西咪替丁剂量增至每天1克后溃疡愈合，此后每天服用600毫克西咪替丁并联合抗酸剂和甲氧氯普胺的维持剂量成功预防了复发。这项对巴雷特食管患者的长期研究表明：1）西咪替丁可有效治疗此类患者；2）多药联合作为维持方案的预防价值；3）仔细随访的重要性。
