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十二指肠溃疡病患者在使用雷尼替丁和兰索拉唑治疗12个月期间及之后,胃窦和胃体部幽门螺杆菌诱导的胃炎变化。

Changes in Helicobacter pylori-induced gastritis in the antrum and corpus during and after 12 months of treatment with ranitidine and lansoprazole in patients with duodenal ulcer disease.

作者信息

Meining A, Kiel G, Stolte M

机构信息

Department of Medicine II, Klinikum rechts der Isar, Technical University of Munich, Germany.

出版信息

Aliment Pharmacol Ther. 1998 Aug;12(8):735-40. doi: 10.1046/j.1365-2036.1998.00370.x.

Abstract

BACKGROUND

Several studies have shown that acid-suppressing treatment leads to aggravation of Helicobacter pylori gastritis in the corpus. It remains unclear whether this augmentation of the inflammation reverts to baseline after termination of treatment.

METHODS

In 114 H. pylori-infected duodenal ulcer patients we investigated the gastritis parameters in antral and corpus mucosa before treatment, after 6 and 12 months of therapy, and 6 months after termination of treatment with 15 mg lansoprazole or 150 mg ranitidine/day.

RESULTS

Lansoprazole and ranitidine led to a significant aggravation of gastritis in the corpus after 6 and 12 months of treatment. However, while there was no change in gastritis in the antrum with ranitidine, treatment with lansoprazole led to partial elimination of H. pylori with improvement of the inflammation in this part of the stomach. Following termination of therapy, the observed changes reverted to baseline. No increase in intestinal metaplasia and/or atrophy in the antrum or corpus was observed.

CONCLUSION

Both substances are associated with an aggravation of H. pylori gastritis in the corpus. However, only lansoprazole leads to a partial elimination of H. pylori with improvement of the inflammation in the antrum. The changes provoked by acid-suppressing treatment revert to baseline after termination of therapy.

摘要

背景

多项研究表明,抑酸治疗会导致胃体部幽门螺杆菌胃炎加重。目前尚不清楚治疗终止后炎症的这种加重是否会恢复到基线水平。

方法

在114例幽门螺杆菌感染的十二指肠溃疡患者中,我们研究了在治疗前、治疗6个月和12个月后以及用15毫克兰索拉唑或150毫克雷尼替丁/天治疗终止后6个月时胃窦和胃体黏膜的胃炎参数。

结果

治疗6个月和12个月后,兰索拉唑和雷尼替丁均导致胃体部胃炎显著加重。然而,雷尼替丁治疗时胃窦部胃炎无变化,而兰索拉唑治疗导致幽门螺杆菌部分清除,胃的这一部分炎症改善。治疗终止后,观察到的变化恢复到基线水平。未观察到胃窦或胃体部肠化生和/或萎缩增加。

结论

两种药物均与胃体部幽门螺杆菌胃炎加重有关。然而,只有兰索拉唑能导致幽门螺杆菌部分清除,胃窦部炎症改善。抑酸治疗引起的变化在治疗终止后恢复到基线水平。

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