Hotz J, Kark W, Plein K, Wiedbrauck F, Guthke A, Otten O
Klinik für Gastroenterologie, Allgemeines Krankenhaus, Celle.
Leber Magen Darm. 1995 Jul;25(4):165-70.
Omeprazole (OM) has been shown to be superior to H2-Blockers in terms of complete healing rates of gastric (GU) and duodenal ulcers (DU). We investigated in more detail the kinetics of ulcer healing under OM (20 mg mane) compared with ranitidine (RAN 300 mg nocte) in GU (n = 28) and DU (n = 27) by multiple series endoscopy. After endoscopic diagnosis (day 0) patients were allocated to either OM or RAN in a random order. Endoscopic controls were undertaken at day (d) 3, 7, 14, 21, 28, 42 up to complete ulcer healing. The seize of ulcer areas was assessed by independent endocopists estimating the longest and shortest diameter D acc. to the formula A = pi x D1 x D2:4.
In GU and DU cumulating healing rates were sign, higher under OM. In GU and DU, the most striking differences in the absolute and percentual reduction of ulcer seize in favour of OM vs RAN were observed mainly during the first week. At d3 under OM the reduction in DU-area was 43% and at d7 75% compared to a distinctly lower rate under RAN with the corresponding figures of 9% and 61% resp. In GU the mean reduction in area was for IM at d3 41%, at d7 82% in contrast to RAN at d3 of 34% and d7 of 49%. The faster healing during the first week was accompanied by sign more rapid reduction in day-and-night-painscore during OM vs RAN.(ABSTRACT TRUNCATED AT 250 WORDS)
奥美拉唑(OM)在胃溃疡(GU)和十二指肠溃疡(DU)的完全愈合率方面已被证明优于H2阻滞剂。我们通过多次系列内镜检查,更详细地研究了与雷尼替丁(RAN,300mg每晚)相比,GU(n = 28)和DU(n = 27)患者在服用OM(20mg每日一次)时溃疡愈合的动力学。内镜诊断(第0天)后,患者被随机分配至OM或RAN组。在第3、7、14、21、28、42天进行内镜对照检查,直至溃疡完全愈合。溃疡面积大小由独立内镜医师根据公式A = π×D1×D2÷4评估最长和最短直径D来确定。
在GU和DU中,OM治疗下的累积愈合率显著更高。在GU和DU中,主要在第一周观察到OM相对于RAN在溃疡面积绝对和百分比减少方面最显著的差异。在OM治疗下,DU在第3天面积减少43%,第7天减少75%,而RAN相应数字分别为9%和61%,明显更低。在GU中,OM在第3天面积平均减少41%,第7天减少82%,相比之下RAN在第3天为34%,第7天为49%。与RAN相比,OM治疗期间第一周愈合更快,同时昼夜疼痛评分下降也明显更快。(摘要截断于250字)