Collen M J, Wirshup J F
Department of Medicine, Loma Linda University Medical Center, California, USA.
Dig Dis Sci. 1995 Aug;40(8):1687-90. doi: 10.1007/BF02212689.
One hundred twenty-four patients with idiopathic gastric acid hypersecretion (basal acid output greater than 10.0 meq/hr) were prospectively evaluated and treated with ranitidine twice a day. Fifty-four patients (44%) required standard doses of ranitidine 300 mg/day for adequate treatment, and the other 70 patients (56%) required increased doses of ranitidine (mean 994 mg/day, range 600-3000 mg/day). Mean basal acid outputs for these two groups were 14.0 and 16.6 meq/hr, respectively, which were not significantly different. Nevertheless, there was a significant correlation between basal acid output and daily ranitidine dose required for therapy (r = 0.18, P = 0.05). The duration of ranitidine therapy consisted of: < 1 year (N = 46), 1 year (N = 16), 2 years (N = 19), 3 years (N = 22), 4 years (N = 15), 5 years (N = 6). Only five patients required progressive increases in ranitidine during the time of treatment, which consisted of an average of 0.5 dose adjustments per year. No side effects occurred with any of these high doses of ranitidine. These results indicate that, as in Zollinger-Ellison syndrome, ranitidine is effective therapy for patients with idiopathic gastric acid hypersecretion; however, markedly increased doses as large as 3000 mg/day may be required.
对124例特发性胃酸分泌过多（基础酸排量大于10.0meq/小时）的患者进行前瞻性评估，并给予雷尼替丁每日两次治疗。54例患者（44%）需要300mg/天的标准剂量雷尼替丁进行充分治疗，另外70例患者（56%）需要增加雷尼替丁剂量（平均994mg/天，范围600 - 3000mg/天）。这两组的平均基础酸排量分别为14.0和16.6meq/小时，差异无统计学意义。然而，基础酸排量与治疗所需的每日雷尼替丁剂量之间存在显著相关性（r = 0.18，P = 0.05）。雷尼替丁治疗持续时间为：<1年（N = 46），1年（N = 16），2年（N = 19），3年（N = 22），4年（N = 15），5年（N = 6）。治疗期间只有5例患者需要逐渐增加雷尼替丁剂量，平均每年调整0.5次剂量。这些高剂量雷尼替丁均未出现副作用。这些结果表明，与卓艾综合征一样，雷尼替丁对特发性胃酸分泌过多患者是有效的治疗药物；然而，可能需要高达3000mg/天的显著增加剂量。
