Schenk B E, Festen H P, Kuipers E J, Klinkenberg-Knol E C, Meuwissen S G
Department of Gastroenterology, Free University Hospital, Amsterdam, The Netherlands.
Aliment Pharmacol Ther. 1996 Aug;10(4):541-5. doi: 10.1046/j.1365-2036.1996.27169000.x.
To evaluate absorption of protein-bound and unbound cyanocobalamin before and during treatment with omeprazole, and cobalamin levels in patients on long-term treatment with omeprazole.
In eight former duodenal ulcer patients absorption of unbound and protein-bound cobalamin was determined by measuring 24-h urinary excretion of unbound 58Co-cyancobalamin or protein-bound 57Co-cyanocobalamin during a modified Schilling test. Tests were performed before and during treatment with 20 mg and 40 mg omeprazole daily for 9 days. Serum cobalamin levels were assessed in 25 patients with gastro-oesophageal reflux disease (GERD) before and during long-term maintenance therapy with omeprazole. Mean treatment duration was 56 months (range 36-81 months).
Urinary excretion of unbound cobalamin was unchanged with both dosages of omeprazole. Excretion of 57Co-cyanocobalamin, however, decreased significantly during treatment with both 20 mg omeprazole (mean +/- S.E.M.: 1.31 +/- 0.20 vs. 0.54 +/- 0.17%; P < 0.02) and 40 mg omeprazole (1.25 +/- 0.26 vs. 0.29 +/- 0.06%; P < 0.02). Mean serum cobalamin levels (+/- S.E.M.) before and during therapy with omeprazole in GERD patients were 298 +/- 27 and 261 +/- 16 pg/mL (normal range 180-900 pg/mL), respectively (P = N.S.).
Absorption of protein-bound, but not unbound, cyanocobalamin is decreased when measured by a modified Schilling test during treatment with omeprazole. However, no change in serum cobalamin levels was observed in patients with GERD after treatment with omeprazole for up to 7 years.
评估奥美拉唑治疗前及治疗期间蛋白质结合型和非结合型氰钴胺的吸收情况，以及长期接受奥美拉唑治疗患者的钴胺素水平。
对8例既往十二指肠溃疡患者，在改良的希林试验中，通过测量未结合的58Co-氰钴胺或蛋白质结合的57Co-氰钴胺的24小时尿排泄量，来测定非结合型和蛋白质结合型钴胺素的吸收情况。试验在每日服用20毫克和40毫克奥美拉唑治疗前及治疗9天期间进行。对25例胃食管反流病（GERD）患者在奥美拉唑长期维持治疗前及治疗期间评估血清钴胺素水平。平均治疗持续时间为56个月（范围36 - 81个月）。
两种剂量的奥美拉唑均未使非结合型钴胺素的尿排泄量发生改变。然而，在服用20毫克奥美拉唑治疗期间（平均±标准误：1.31±0.20对0.54±0.17%；P < 0.02）和40毫克奥美拉唑治疗期间（1.25±0.26对0.29±0.06%；P < 0.02），57Co-氰钴胺的排泄量均显著降低。GERD患者在奥美拉唑治疗前及治疗期间的平均血清钴胺素水平（±标准误）分别为298±27和261±16 pg/mL（正常范围180 - 900 pg/mL）（P = 无显著性差异）。
在用改良希林试验测量时，奥美拉唑治疗期间蛋白质结合型而非非结合型氰钴胺的吸收减少。然而，GERD患者在接受奥美拉唑治疗长达7年后，未观察到血清钴胺素水平发生变化。
