Altomare D F, Lupo L, Pannarale O C, Di Corcia M G, Memeo V
Institute of Clinica Chirurgica, Università di Bari, Italy.
Eur J Surg. 1995 Feb;161(2):109-13.
To assess the effect of ranitidine on cellular immune response (and postoperative infective morbidity) in a homogeneous group of patients.
Prospective randomized controlled trial.
University hospital, Italy.
42 patients about to undergo curative resection for carcinoma of the colon, rectum, or stomach.
Cell mediated immunity was tested 3 days before, and 4 days after, operation by reactions to 7 recall antigens (Multitest, Merieux). 21 patients were randomly allocated to receive ranitidine 100 mg twice daily intravenously from the day before operation until the third postoperative day.
Comparison of the number of reactive patients and number of positive antigens before and after operation; and correlation between reactivity and incidence of postoperative infective complications.
The median (range) skin test scores preoperatively were: ranitidine group 8.5 (0-17), and control group 10 (0-19). The postoperative figures were 7 (0-28) and 4.5 (0-15.5) respectively. The corresponding numbers of positive antigens were 1 (0-4) and 3 (0-4) compared with 1 (0-5) and 1 (0-3). The changes in the scores did not seem to be influenced by blood transfusion, serum albumin concentration, age of the patient, or type of tumour. Two patients died in the ranitidine group (pulmonary embulus, n = 1, necrotising pancreatitis, n = 1) and there were 4 wound infections. There were no deaths in the control group, one intra-abdominal abscess, and 8 wound infections. Median hospital stay was similar, 10 (8-16) in the ranitidine group, and 11 (5-20) in the control group.
Ranitidine had a beneficial effect on cell-mediated immunity as it seemed to prevent the usual postoperative reduction in reactivity, but there was no significant difference in the incidence of infective complications though it was lower in the ranitidine group.
评估雷尼替丁对一组同质化患者细胞免疫反应（及术后感染性发病率）的影响。
前瞻性随机对照试验。
意大利大学医院。
42例即将接受结肠癌、直肠癌或胃癌根治性切除术的患者。
术前3天及术后4天通过对7种回忆抗原（梅里埃公司的多重检测）的反应来检测细胞介导免疫。21例患者被随机分配，从手术前一天开始至术后第三天，每天静脉注射雷尼替丁100毫克，每日两次。
比较手术前后反应性患者数量和阳性抗原数量；以及反应性与术后感染性并发症发生率之间的相关性。
术前皮肤试验评分中位数（范围）为：雷尼替丁组8.5（0 - 17），对照组10（0 - 19）。术后相应数字分别为7（0 - 28）和4.5（0 - 15.5）。阳性抗原相应数量分别为1（0 - 4）和3（0 - 4），而术前为1（0 - 5）和1（0 - 3）。评分变化似乎不受输血、血清白蛋白浓度、患者年龄或肿瘤类型的影响。雷尼替丁组有2例患者死亡（肺栓塞，1例；坏死性胰腺炎，1例），有4例伤口感染。对照组无死亡病例，有1例腹腔内脓肿和8例伤口感染。中位住院时间相似，雷尼替丁组为10（8 - 16）天，对照组为11（5 - 20）天。
雷尼替丁对细胞介导免疫有有益作用，因为它似乎可防止术后常见的反应性降低，但感染性并发症发生率虽在雷尼替丁组较低，但无显著差异。
