Stolte M, Meining A, Schmitz J M, Alexandridis T, Seifert E
Institut für Pathologie, Klinikum Bayreuth, Germany.
Aliment Pharmacol Ther. 1998 Mar;12(3):247-53. doi: 10.1046/j.1365-2036.1998.00310.x.
Several studies have shown that treatment with omeprazole leads to aggravation of Helicobacter pylori gastritis in the corpus. Whether this also applies to lansoprazole, and whether, in comparison with omeprazole, there are differences in therapy-induced gastritis parameter changes remains unclear.
In 111 patients infected with H. pylori and with gastro-oesophageal reflux disease we investigated the gastritis parameters in antral and corpus mucosa before and after 2, 6 and 12 months of treatment with 15 or 30 mg lansoprazole or 20 mg omeprazole/day.
In all groups the different treatments had a similar effect: in both regions of the stomach, suppression or partial elimination of H. pylori was seen. However, improvement in the inflammation was observed only in the antrum, while in the corpus most gastritis parameters worsened significantly. There was no increase in intestinal metaplasia or atrophy.
In common with omeprazole, lansoprazole aggravates the gastritis parameters in the corpus but improves them in the antrum. Treatment with proton pump inhibitors does not result in any increase in the incidence of atrophy/intestinal metaplasia. However, as gastritis predominating in the corpus seems to be associated with an elevated carcinogenic risk, consideration should be given to prophylactic H. pylori eradication therapy before initiating proton pump inhibitor treatment.
多项研究表明，使用奥美拉唑治疗会导致胃体部幽门螺杆菌胃炎加重。兰索拉唑是否也如此，以及与奥美拉唑相比，治疗引起的胃炎参数变化是否存在差异尚不清楚。
在111例感染幽门螺杆菌且患有胃食管反流病的患者中，我们研究了每日服用15或30mg兰索拉唑或20mg奥美拉唑治疗2、6和12个月前后胃窦和胃体黏膜的胃炎参数。
在所有组中，不同治疗方法有相似的效果：在胃的两个区域均可见幽门螺杆菌被抑制或部分清除。然而，仅在胃窦部观察到炎症改善，而在胃体部大多数胃炎参数显著恶化。肠化生或萎缩未见增加。
与奥美拉唑一样，兰索拉唑会加重胃体部的胃炎参数，但会改善胃窦部的参数。质子泵抑制剂治疗不会导致萎缩/肠化生发生率增加。然而，由于以胃体部为主的胃炎似乎与致癌风险升高有关，在开始质子泵抑制剂治疗前应考虑进行预防性幽门螺杆菌根除治疗。
