Cadiot G, Vissuzaine C, Pospai D, Ruszniewski P, Potet F, Mignon M
Service d'Hépato-Gastroentérologie, Hôpital Bichat-Claude Bernard, Paris.
Gastroenterol Clin Biol. 1995 Oct;19(10):811-7.
To evaluate the evolution of fundic argyrophil cell density and hyperplasia grading, fundic chronic gastritis grading and serum gastrin levels in patients treated with proton pump inhibitors.
Thirty-two patients treated with proton pump inhibitors for gastroesophageal reflux and/or duodenal ulcer were studied. No patient had a gastric ulcer. The studied parameters were serum gastrin levels, fundic argyrophil cell density, the degree of fundic argyrophil cell hyperplasia, the grade of fundic atrophic gastritis and the presence of Helicobacter pylori. The first point of the study was 7 months (range: 0-42 months) and the last point 33 months (range: 7-72 months) after the beginning of the treatment.
Serum gastrin levels significantly increased with treatment. Fundic argyrophil cell density did not change significantly. In 3 patients (9%), serum gastrin levels were twice the normal upper limit. The highest serum gastrin levels (249 and 665 pg/mL) were noted in the 2 patients treated with the highest doses of proton pump inhibitors. Micronodular hyperplasia of the fundic argyrophil cells was observed in 2 patients treated with omeprazole 20 mg/d for 4 years and lansoprazole 90 mg/d for 6 years, respectively. Non active superficial chronic gastritis was noted in 2 patients. Serum gastrin levels were significantly correlated with cell densities.
There were minor modifications of fundic argyrophil cell population and of gastrinaemia during the study period. They were not related to chronic atrophic gastritis. However, survey is mandatory in patients treated with high dose proton pump inhibitors, in those in whom gastrinaemia is elevated and when treatment duration is longer than 5 years.
评估接受质子泵抑制剂治疗的患者胃底嗜银细胞密度及增生分级、胃底慢性胃炎分级和血清胃泌素水平的变化。
对32例因胃食管反流和/或十二指肠溃疡接受质子泵抑制剂治疗的患者进行研究。所有患者均无胃溃疡。研究参数包括血清胃泌素水平、胃底嗜银细胞密度、胃底嗜银细胞增生程度、胃底萎缩性胃炎分级以及幽门螺杆菌的存在情况。研究的第一个时间点为治疗开始后7个月（范围：0 - 42个月），最后一个时间点为治疗开始后33个月（范围：7 - 72个月）。
治疗期间血清胃泌素水平显著升高。胃底嗜银细胞密度无显著变化。3例患者（9%）血清胃泌素水平是正常上限的两倍。在接受最高剂量质子泵抑制剂治疗的2例患者中，观察到血清胃泌素水平最高（分别为249和665 pg/mL）。分别在1例接受20 mg/d奥美拉唑治疗4年和1例接受90 mg/d兰索拉唑治疗6年的患者中观察到胃底嗜银细胞的微结节状增生。2例患者出现非活动性浅表性慢性胃炎。血清胃泌素水平与细胞密度显著相关。
在研究期间，胃底嗜银细胞群体和胃泌素血症有轻微改变。它们与慢性萎缩性胃炎无关。然而，对于接受高剂量质子泵抑制剂治疗的患者、胃泌素血症升高的患者以及治疗持续时间超过5年的患者，必须进行监测。
