Vetvik K, Schrumpf E, Mowinckel P, Aase S, Andersen K J
Mandal Hospital, Norway.
Scand J Gastroenterol. 1994 Nov;29(11):995-1000. doi: 10.3109/00365529409094876.
Duodenal and gastric content of mucosal enzymes in duodenal ulcer (DU) patients differs from that of controls. The purpose of this study has been to examine the effect of omeprazole and eradication of Helicobacter pylori on mucosal enzymes in DU patients.
The enzyme activities of seven gastric and duodenal mucosal marker enzymes from the brush border, lysosomes, and mitochondria have been studied. In study I the measurements were made in 29 patients with an active DU before and after 14 days of omeprazole treatment. In study II 22 duodenal ulcer patients were given bismuth subnitrate, oxytetracycline, and metronidazole (triple therapy) for 2 weeks to eradicate H. pylori. Biopsy specimens were taken from the duodenum and the stomach for enzyme measurements and histologic assessment. In study II additional specimens were obtained from the prepyloric region for urease tests and culture of H. pylori.
The ulcer healing rates were more than 90% after both omeprazole and triple therapy. H. pylori was eradicated in 86% after triple therapy. The activities of the brush-border enzymes lactase, neutral-alpha-glucosidase, alkaline phosphatase, leucyl-beta-naphthylamidase, and gamma-glutamyltransferase (gamma-GT) increased significantly in the duodenal bulb and the descending duodenum during treatment with omeprazole. No changes in duodenal enzyme activity were detected after triple therapy, whereas a significant fall in gamma-GT and acid phosphatase activities was seen in the stomach. The mucosal DNA in the gastric antrum decreased both after treatment with omeprazole and after triple therapy.
A similar decrease in mucosal DNA of the gastric antrum was demonstrated after both omeprazole and triple therapy with bismuth subnitrate, oxytetracycline, and metronidazole. Omeprazole also affects the content of duodenal mucosal enzymes, whereas triple therapy particularly affects the gastric mucosal enzyme activity.
十二指肠溃疡（DU）患者十二指肠和胃黏膜酶的含量与对照组不同。本研究的目的是探讨奥美拉唑和根除幽门螺杆菌对DU患者黏膜酶的影响。
研究了来自刷状缘、溶酶体和线粒体的七种胃和十二指肠黏膜标记酶的活性。在研究I中，对29例活动性DU患者在奥美拉唑治疗14天前后进行了测量。在研究II中，22例十二指肠溃疡患者接受次硝酸铋、土霉素和甲硝唑（三联疗法）治疗2周以根除幽门螺杆菌。从十二指肠和胃采集活检标本进行酶测量和组织学评估。在研究II中，从幽门前区域获取额外标本进行尿素酶试验和幽门螺杆菌培养。
奥美拉唑和三联疗法后溃疡愈合率均超过90%。三联疗法后86%的幽门螺杆菌被根除。在奥美拉唑治疗期间，十二指肠球部和十二指肠降部的刷状缘酶乳糖酶、中性α-葡萄糖苷酶、碱性磷酸酶、亮氨酰-β-萘基酰胺酶和γ-谷氨酰转移酶（γ-GT）的活性显著增加。三联疗法后未检测到十二指肠酶活性变化，而胃中γ-GT和酸性磷酸酶活性显著下降。奥美拉唑治疗后和三联疗法后胃窦黏膜DNA均减少。
奥美拉唑和次硝酸铋、土霉素和甲硝唑三联疗法后胃窦黏膜DNA均有类似下降。奥美拉唑还影响十二指肠黏膜酶的含量，而三联疗法尤其影响胃黏膜酶活性。
