Katsu K, Yabe S
Third Division of Internal Medicine, Saitama Medical School, Japan.
Clin Ther. 1995 May-Jun;17(3):433-10. doi: 10.1016/0149-2918(95)80108-1.
Gastric mucosal surface pH was measured endoscopically in patients with peptic ulcer, erosive gastritis, or nonulcer dyspepsia following intravenous administration of either 200-mg cimetidine, 50-mg ranitidine, or 40-mg famotidine. The mean baseline pH in the three treatment groups before drug administration ranged from 0.85 to 0.99, with no significant difference between groups. Following treatment with cimetidine, ranitidine, and famotidine, the mean response times for the mucosal surface pH values to increase to 3.5 were 10.1 +/- 5.9 minutes, 11.2 +/- 6.8 minutes, and 17.3 +/- 6.7 minutes, respectively. The corresponding response times to reach pH levels of 6.0 were 16.0 +/- 9.4 minutes, 17.0 +/- 5.4 minutes, and 31.2 +/- 21.7 minutes, respectively. The response times to pH levels of 3.5 and 6.0 were significantly faster in patients who received cimetidine compared with patients who received famotidine (P = 0.0088 to pH 3.5 and P = 0.046 to pH 6.0). The differences between cimetidine and ranitidine were not significant. These findings suggest that at recommended clinical doses, intravenous cimetidine provides rapid elevation of the gastric mucosal surface pH compared with other histamine2-receptor antagonists. This finding may be particularly relevant in the emergency care of patients with severe peptic ulcer disease (eg, patients with gastrointestinal hemorrhage).
对患有消化性溃疡、糜烂性胃炎或非溃疡性消化不良的患者，在静脉注射200毫克西咪替丁、50毫克雷尼替丁或40毫克法莫替丁后，通过内镜测量胃黏膜表面pH值。给药前三个治疗组的平均基线pH值在0.85至0.99之间，组间无显著差异。使用西咪替丁、雷尼替丁和法莫替丁治疗后，胃黏膜表面pH值升至3.5的平均反应时间分别为10.1±5.9分钟、11.2±6.8分钟和17.3±6.7分钟。达到pH值6.0的相应反应时间分别为16.0±9.4分钟、17.0±5.4分钟和31.2±21.7分钟。与接受法莫替丁的患者相比，接受西咪替丁的患者达到pH值3.5和6.0的反应时间明显更快（pH值3.5时P = 0.0088，pH值6.0时P = 0.046）。西咪替丁和雷尼替丁之间的差异不显著。这些发现表明，在推荐的临床剂量下，与其他组胺2受体拮抗剂相比，静脉注射西咪替丁能使胃黏膜表面pH值迅速升高。这一发现可能在严重消化性溃疡疾病患者（如胃肠道出血患者）的急诊护理中尤为重要。
