Tarnawski A, Santos A M, Hanke S, Stachura J, Douglass T G, Sarfeh I J
Dept. of Veterans Affairs Medical Center, Long Beach, CA 90822, USA.
Scand J Gastroenterol Suppl. 1995;208:9-13. doi: 10.3109/00365529509107755.
Chronic administration of sucralfate (SCR), a non-systemic ulcer-healing drug, exerts a trophic action on the gastric mucosa and prevents or reduces ulcer recurrence. The aim of this study was to determine whether SCR and/or the acid inhibiting drug omeprazole (OME) may affect the quality of ulcer healing, i.e., restoration of mucosal architecture.
Gastric ulcers were produced in male rats by serosal application of acetic acid. Rats were gavaged twice daily for 14 days with 2 ml of: (a) Placebo (PLA), (b) SCR 500 mg/kg, or (c) OME, 50 mg/kg starting 48 h after ulcer induction. We determined ulcer size under a dissecting microscope, and performed quantitative histologic assessment of quality of healing score (QS) on a scale from 0 (normal) to 5 (most abnormal).
Ulcer size was 1.4 +/- 0.15 mm in the PLA group, 0.61 +/- 0.1 mm in the SCR group and 0.86 +/- 0.13 mm in the OME group (both OME and SCR p < 0.01 versus PLA). In the PLA group, histology showed (in rats with ulcers) a well-developed ulcer margin with cystically dilated glands. The QS of the ulcer scar in the PLA group was 3.3 +/- 0.22. IN the SCR-treated group, within the scar gastric glands were less dilated, more vertically oriented and the healing zone and granulation tissue were well developed and organized. The QS was 1.6 +/- 0.2, p < 0.001 versus PLA and OME. In the OME group, the ulcer margin and the scar were thinner-reduction of mucosal thickness by 43 +/- 2% (p < 0.005) and 18 +/- 1%, respectively, versus SCR and PLA groups. The number of dilated glands and connective tissue components in the scar was increased by 60%. The QS was 3.6 +/- 0.3.
(1) Both SCR and OME significantly reduced the size of the experimental gastric ulcer. (2) Restoration of mucosal architecture, assessed quantitatively, was much better in the SCR than in the OME and PLA-treated groups. (3) a trophic action of SCR on the gastric mucosa may be the basis of better quality of ulcer healing with SCR.
硫糖铝（SCR）是一种非系统性溃疡愈合药物，长期给药对胃黏膜具有营养作用，可预防或减少溃疡复发。本研究旨在确定SCR和/或抑酸药物奥美拉唑（OME）是否会影响溃疡愈合质量，即黏膜结构的恢复。
通过在雄性大鼠浆膜面涂抹醋酸制作胃溃疡。造模后48小时起，大鼠每天灌胃2次，连续14天，每次2ml：（a）安慰剂（PLA）；（b）500mg/kg SCR；或（c）50mg/kg OME。在解剖显微镜下测定溃疡大小，并对愈合质量评分（QS）进行定量组织学评估，评分范围为0（正常）至5（最异常）。
PLA组溃疡大小为1.4±0.15mm，SCR组为0.61±0.1mm，OME组为0.86±0.13mm（与PLA组相比，OME组和SCR组p均<0.01）。在PLA组，组织学显示（溃疡大鼠）溃疡边缘发达，腺体呈囊性扩张。PLA组溃疡瘢痕的QS为3.3±0.22。在SCR治疗组，瘢痕内胃腺体扩张程度较小，更垂直排列，愈合区和肉芽组织发育良好且结构有序。QS为1.6±0.2，与PLA组和OME组相比p<0.001。在OME组，溃疡边缘和瘢痕较薄，黏膜厚度分别比SCR组和PLA组减少43±2%（p<0.005）和18±1%。瘢痕内扩张腺体和结缔组织成分数量增加60%。QS为3.6±0.3。
（1）SCR和OME均显著减小了实验性胃溃疡的大小。（2）定量评估显示，SCR组黏膜结构的恢复明显优于OME组和PLA治疗组。（3）SCR对胃黏膜的营养作用可能是其溃疡愈合质量更好的基础。
