Salim A S
University Department of Surgery, Medical City, Baghdad, Iraq.
Can J Surg. 1993 Feb;36(1):53-8.
In a double-blind study involving 172 patients, the author investigated the effect of sulfhydryl-containing agents (cysteine and methylmethionine sulfonium chloride [MMSC]) on hematemesis resulting from erosive gastritis induced by nonsteroidal anti-inflammatory drugs. The 56 patients who received cysteine (200 mg orally four times a day) and the 59 patients who received MMSC (500 mg orally four times a day) were significantly (p < 0.01) more hemodynamically stable, with no rebleeding, than the 57 patients who made up a control group. Endoscopy carried out 48 hours after admission demonstrated that gastric erosions were still present in a significantly (p < 0.01) higher number of patients in the control group (20 [35%]) than in patients receiving cysteine (6 [11%]) and in patients receiving MMSC (7 [12%]). Eighteen patients (32%) in the control group required blood transfusion because of continued bleeding or rebleeding compared with only 3 patients (5%) receiving cysteine and 2 patients (3%) receiving MMSC (p < 0.01). Emergency surgery was necessary in 13 patients (23%) in the control group and in 1 patient (2%) in the group receiving cysteine who had rebleeding. Four patients in the control group died postoperatively. The results show that sulfhydryl-containing agents stimulate the healing of erosive gastritis induced by nonsteroidal anti-inflammatory drugs and protect against the complications of bleeding produced by the gastritis.
在一项涉及172名患者的双盲研究中，作者调查了含巯基药物（半胱氨酸和氯化甲基蛋氨酸[MMSC]）对非甾体抗炎药引起的糜烂性胃炎所致呕血的影响。接受半胱氨酸治疗的56名患者（每日口服4次，每次200毫克）和接受MMSC治疗的59名患者（每日口服4次，每次500毫克）在血流动力学上明显（p<0.01）更稳定，且无再出血情况，这优于组成对照组的57名患者。入院48小时后进行的内镜检查显示，对照组中仍有明显（p<0.01）更多的患者存在胃糜烂（20例[35%]），而接受半胱氨酸治疗的患者中为6例（11%），接受MMSC治疗的患者中为7例（12%）。对照组中有18名患者（32%）因持续出血或再出血需要输血，而接受半胱氨酸治疗的患者中只有3例（5%），接受MMSC治疗的患者中只有2例（3%）（p<0.01）。对照组中有13名患者（23%）需要进行急诊手术，接受半胱氨酸治疗的组中有1例（2%）患者出现再出血而需要手术。对照组中有4名患者术后死亡。结果表明，含巯基药物可刺激非甾体抗炎药引起的糜烂性胃炎的愈合，并预防胃炎所致出血的并发症。
