Bernaldo de Quirós González J, Reverte Cejudo D, Galilea Bazaco I, Fernández Rubio E
Med Clin (Barc). 1981 Feb 10;76(3):113-6.
In the case that long term treatment with cimetidine could lead to a reduction of the parietal cell mass, there would result important therapeutic consequences. To investigate this possibility, 26 patients with duodenal ulcer were prospectively studied while on treatment with 1 g daily of cimetidine for two six-month periods separated by a two-week interruption of the therapy. No significant changes in pentagastrin-stimulated gastric acid secretion were observed after seven to 14 days off cimetidine, following six and twelve months of treatment. Cimetidine therapy had a significant effect on ulcer pain and antacid consumption. There were reductions of 11% and 10% from the initial figures in the proportion of ulcer niches seen endoscopically, after six in twelve months of treatment respectively. Some patients without a visible duodenal niche on initial endoscopy showed one at subsequent examinations. The sudden interruption of cimetidine treatment after six months was followed by the development of a gastric ulcer, previously absent, in three patients, one of whom had an upper gastrointestinal haemorrhage. There were no extragastric complications in spite of the doses and the duration of treatment. The authors consider that maintaining patients on one gram per day of cimetidine for one year is useless.
如果长期使用西咪替丁治疗可能导致壁细胞数量减少,将会产生重要的治疗后果。为了研究这种可能性,对26例十二指肠溃疡患者进行了前瞻性研究,患者接受每日1克西咪替丁治疗,为期两个六个月疗程,中间停药两周。在治疗六个月和十二个月后,停用西咪替丁7至14天后,未观察到五肽胃泌素刺激的胃酸分泌有显著变化。西咪替丁治疗对溃疡疼痛和抗酸剂用量有显著影响。治疗六个月和十二个月后,内镜下所见溃疡龛影的比例分别较初始数值降低了11%和10%。一些初始内镜检查时无可见十二指肠龛影的患者在后续检查中出现了龛影。六个月后突然停用西咪替丁治疗,三名患者出现了先前不存在的胃溃疡,其中一名患者发生了上消化道出血。尽管治疗剂量和疗程如此,仍未出现胃外并发症。作者认为让患者每日服用1克西咪替丁维持治疗一年并无益处。