Bank S, Blumstein M, Greenberg R E, Magier D, Lavin P T
Long Island Jewish Medical Center, New Hyde Park, New York.
Clin Ther. 1993 Jan-Feb;15(1):36-45.
Seventy-one of 85 consecutive patients with endoscopically confirmed active benign gastric ulcers completed an 8-week study to evaluate the effects on healing of famotidine 40 mg given as a single dose at night. The healing rate in the 48 patients in whom the ulcers were associated with nonsteroidal anti-inflammatory drug (NSAID) or aspirin (ASA) use was compared with that in the 23 patients with idiopathic ulcers. Endoscopy, symptom assessments, antacid use, hematology, and serum chemistry were performed at weeks 4 and 8 of treatment. Famotidine 40 mg at bedtime healed 63 (89%) of the 71 ulcers at 8 weeks; the healing rate for NSAID/ASA-associated ulcers was 46 (96%) of 48, which was significantly greater than that for idiopathic ulcers (17 of 23; 74%) (P = 0.0119). Of the 54 patients who returned a questionnaire 1 to 2 years after completing the study, 20% were still taking an NSAID/ASA (mainly for cardiovascular prophylaxis). About half of the patients surveyed were taking anti-ulcer medication. None of these patients had experienced any serious ulcer complication. The results of this study suggest that differentiating NSAID/ASA-induced ulcers from idiopathic ulcers may be important with regard to healing rates and duration of therapy.
85例经内镜确诊为活动性良性胃溃疡的连续患者中有71例完成了一项为期8周的研究,以评估夜间单次服用40毫克法莫替丁对溃疡愈合的影响。将48例溃疡与使用非甾体抗炎药(NSAID)或阿司匹林(ASA)相关的患者的愈合率与23例特发性溃疡患者的愈合率进行比较。在治疗的第4周和第8周进行内镜检查、症状评估、抗酸剂使用情况、血液学和血清化学检查。8周时,睡前服用40毫克法莫替丁使71例溃疡中的63例(89%)愈合;NSAID/ASA相关溃疡的愈合率为48例中的46例(96%),显著高于特发性溃疡(23例中的17例;74%)(P = 0.0119)。在完成研究1至2年后返回问卷的54例患者中,20%仍在服用NSAID/ASA(主要用于心血管预防)。约一半接受调查的患者正在服用抗溃疡药物。这些患者均未发生任何严重的溃疡并发症。本研究结果表明,就愈合率和治疗持续时间而言,区分NSAID/ASA诱导的溃疡和特发性溃疡可能很重要。