Bardhan K D, Cherian P, Jones R B, Vaishnavi A, Manek S, Bishop A, Polak J, Brooks A, Morris P, Thompson M, D'Silva J, Parkin S, Patterson J, Gillon K R
Rotherham General Hospitals NHS Trust, United Kingdom.
Ital J Gastroenterol Hepatol. 1997 Dec;29(6):515-9.
Erosive oesophagitis refractory to high dose histamine H2 receptor antagonists (definition: failure to heal fully after > or = 3 months' treatment with cimetidine 3.2 g or ranitidine 0.9 g) responds well to omeprazole 40 mg daily but frequently relapses when the patients are put back on maintenance H2 receptor antagonists at medium or even high dose (e.g. cimetidine 1.6 g and 3.2 g, respectively).
To investigate the efficacy of maintenance omeprazole 20 mg daily in refractory erosive oesophagitis.
PATIENTS & METHODS: In this open, sequential study, patients with H2 receptor antagonist-refractory oesophagitis were healed on omeprazole 40 mg daily and then put on maintenance H2 receptor antagonists (cimetidine 1.6 g or 3.2 g). Relapses were re-treated with omeprazole 40 mg; upon rehealing, patients were put on maintenance omeprazole 20 mg daily for up to 4.5 years.
Healing on omeprazole occurred in 38 out of 39 patients (97%) at 12 weeks. Only six of the 38 patients (16%) relapsed (asymptomatic in half) during subsequent maintenance treatment, whereas all had relapsed earlier on high dose H2 receptor antagonists.
Within the limits of interpretation of an open study, omeprazole 20 mg daily seems effective in maintaining prolonged remission in this group of patients with H2 receptor antagonist-refractory oesophagitis.
高剂量组胺H2受体拮抗剂治疗无效的糜烂性食管炎（定义：使用西咪替丁3.2 g或雷尼替丁0.9 g治疗≥3个月后未完全愈合）对每日40 mg奥美拉唑反应良好，但当患者重新使用中等剂量甚至高剂量的H2受体拮抗剂维持治疗时（如分别使用西咪替丁1.6 g和3.2 g），常出现复发。
研究每日20 mg奥美拉唑维持治疗难治性糜烂性食管炎的疗效。
在这项开放性序贯研究中，对H2受体拮抗剂治疗无效的食管炎患者先给予每日40 mg奥美拉唑使其愈合，然后给予H2受体拮抗剂维持治疗（西咪替丁1.6 g或3.2 g）。复发时重新使用40 mg奥美拉唑治疗；再次愈合后，患者给予每日20 mg奥美拉唑维持治疗，最长达4.5年。
39例患者中有38例（97%）在12周时使用奥美拉唑愈合。在随后的维持治疗期间，38例患者中只有6例（16%）复发（半数无症状），而所有患者在早期使用高剂量H2受体拮抗剂时均复发。
在开放性研究的解释范围内，每日20 mg奥美拉唑似乎能有效维持这组H2受体拮抗剂治疗无效的食管炎患者的长期缓解。
