Salim A S
Surg Gynecol Obstet. 1993 May;176(5):484-90.
The effect of the free radical scavengers allopurinol (50 milligrams) and dimethyl sulfoxide (DMSO) (500 milligrams), taken orally four times a day, on the clinical outcome of hematemesis resulting from nonsteroidal anti-inflammatory drugs (NSAID) induced erosive gastritis was examined in a prospective randomized double-blinded controlled trial. In 180 fully evaluable patients with osteoarthritis or rheumatoid arthritis, administration of allopurinol (n = 63) or DMSO (n = 58) enabled significantly (p < 0.01) larger numbers of patients to remain hemodynamically stable with no rebleed relative to those in the control group (n = 59). The results of endoscopic examination 48 hours after admission demonstrated that gastric erosions were still present in significantly more patients in the control group (p < 0.01; n = 20; 50 percent) than in the allopurinol (n = 5; 9 percent) or DMSO (n = 4; 7 percent) groups. The radical scavengers also reduced the number of patients requiring blood transfusion because of a rebleed or continued bleeding and emergency operation relative to control values. It is, thus, construed that oxygen derived free radicals mediate the mechanism of NSAID induced erosive gastritis. Scavenging these radicals impairs the gastritis, stimulates healing and protects against the complications of its hemorrhagic episodes.
在一项前瞻性随机双盲对照试验中，研究了自由基清除剂别嘌醇（50毫克）和二甲基亚砜（DMSO）（500毫克），每日口服4次，对非甾体抗炎药（NSAID）引起的糜烂性胃炎所致呕血临床结局的影响。在180例可进行全面评估的骨关节炎或类风湿关节炎患者中，与对照组（n = 59）相比，服用别嘌醇（n = 63）或DMSO（n = 58）能使显著更多（p < 0.01）的患者血流动力学保持稳定且无再出血。入院48小时后的内镜检查结果显示，对照组中仍有明显更多患者存在胃糜烂（p < 0.01；n = 20；50%），而别嘌醇组（n = 5；9%）或DMSO组（n = 4；7%）则较少。与对照组相比，自由基清除剂还减少了因再出血或持续出血而需要输血以及进行急诊手术的患者数量。因此，可以推断氧衍生自由基介导了NSAID引起的糜烂性胃炎的发病机制。清除这些自由基可减轻胃炎，促进愈合，并预防其出血并发症。
