Boixeda D, Gisbert J P, Vila T, Cantón R, Redondo C, Martín de Argila C, Cano A, García Plaza A
Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid.
Rev Clin Esp. 1995 Apr;195(4):214-9.
Hyperpepsinogenaemia has long been considered an important factor in the pathophysiology of duodenal ulcer. Moreover, H. pylori infection has been reported in virtually all duodenal ulcers. OBJECTIVE. To demonstrate the influence of H. pylori eradication on basal pepsinogen I levels in patients with duodenal ulcer. METHODS. 86 patients with endoscopically proven duodenal ulcer were prospectively studied. Different therapeutic regimens were used: Amoxycillin/clavulanate plus omeprazole or ranitidine, triple therapy, omeprazole and ranitidine. At diagnostic endoscopy and after therapy, three biopsy samples were taken from different levels and analyzed by microbiological and histological methods; also, basal pepsinogen I levels were measured. RESULTS. H pylori eradication was associated with a significant histological improvement (p < 0.001), both in gastric antrum and corpus. In patients where H. pylori was eradicated pepsinogen I levels decreased from 107.6 +/- 31 ng/ml to 79.7 +/- 32 ng/ml after therapy (p < 0.001); however, when eradication was not achieved differences were not significant. CONCLUSION. H pylori eradication in patients with duodenal ulcer was associated with a significant decrease in basal pepsinogen I levels. The verification of such a decrease could represent a useful non-invasive method to monitor the efficiency of therapy, both in H. pylori eradication and in the resolution of the associated gastritis. This procedure is also associated with early results and a low cost.
高胃蛋白酶原血症长期以来一直被认为是十二指肠溃疡病理生理学中的一个重要因素。此外,几乎所有十二指肠溃疡患者都报告有幽门螺杆菌感染。目的:证明根除幽门螺杆菌对十二指肠溃疡患者基础胃蛋白酶原I水平的影响。方法:对86例经内镜证实为十二指肠溃疡的患者进行前瞻性研究。采用了不同的治疗方案:阿莫西林/克拉维酸加奥美拉唑或雷尼替丁、三联疗法、奥美拉唑和雷尼替丁。在诊断性内镜检查时和治疗后,从不同层面取三个活检样本,用微生物学和组织学方法进行分析;同时,测量基础胃蛋白酶原I水平。结果:根除幽门螺杆菌与胃窦和胃体的组织学显著改善相关(p<0.001)。在根除幽门螺杆菌的患者中,治疗后胃蛋白酶原I水平从107.6±31 ng/ml降至79.7±32 ng/ml(p<0.001);然而,未实现根除时差异不显著。结论:十二指肠溃疡患者根除幽门螺杆菌与基础胃蛋白酶原I水平显著降低相关。证实这种降低可能是一种有用的非侵入性方法,可用于监测幽门螺杆菌根除治疗和相关胃炎消退的治疗效果。该方法还具有早期结果和低成本的特点。