Tari A, Hamada M, Kamiyasu T, Sumii K, Haruma K, Inoue M, Kishimoto S, Kajiyama G, Walsh J H
Department of Internal Medicine, Hiroshima Red Cross Hospital, Japan.
Dig Dis Sci. 1997 Aug;42(8):1741-6. doi: 10.1023/a:1018825902055.
This study was performed to examine the effects of additional enprostil administration on hypergastrinemia and gastric acid suppression induced by omeprazole. Serum gastrin concentrations were measured in 10 peptic ulcer patients (six Helicobacter pylori-positive and four Helicobacter pylori-negative patients) before treatment, after two weeks of omeprazole (20 mg/day), and after two weeks of omeprazole and enprostil (50 micrograms/day). The additional acid inhibitory effect of enprostil was evaluated by 24-hr intragastric pH measurements in five healthy Helicobacter pylori-negative volunteers. After omeprazole treatment, the serum gastrin level of Helicobacter pylori-positive patients (3.5-fold of control) was markedly higher than that of Helicobacter pylori-negative patients (1.7-fold of control). Additional treatment with enprostil suppressed serum gastrin levels to 0.4-fold and 0.7-fold of omeprazole treatment levels in Helicobacter pylori-positive and Helicobacter pylori-negative patients, respectively. In healthy volunteers, median pH recorded during the nonmeal daytime interval increased significantly with additional enprostil. Thus, enprostil reduces undesirable omeprazole-induced hypergastrinemia, especially in Helicobacter pylori-positive patients, and effectively suppresses acid secretion.
本研究旨在探讨额外给予恩前列素对奥美拉唑诱导的高胃泌素血症和胃酸抑制的影响。在10例消化性溃疡患者（6例幽门螺杆菌阳性和4例幽门螺杆菌阴性患者）治疗前、接受奥美拉唑（20mg/天）治疗两周后以及接受奥美拉唑和恩前列素（50微克/天）治疗两周后，测定血清胃泌素浓度。通过对5名健康幽门螺杆菌阴性志愿者进行24小时胃内pH值测量，评估恩前列素的额外抑酸作用。奥美拉唑治疗后，幽门螺杆菌阳性患者的血清胃泌素水平（为对照值的3.5倍）显著高于幽门螺杆菌阴性患者（为对照值的1.7倍）。在幽门螺杆菌阳性和幽门螺杆菌阴性患者中，额外给予恩前列素治疗分别将血清胃泌素水平抑制至奥美拉唑治疗水平的0.4倍和0.7倍。在健康志愿者中，非进餐白天时段记录的pH值中位数随着额外给予恩前列素而显著升高。因此，恩前列素可减轻奥美拉唑引起的不良高胃泌素血症，尤其是在幽门螺杆菌阳性患者中，并有效抑制胃酸分泌。
