兰索拉唑对十二指肠溃疡愈合、幽门螺杆菌清除和生长的作用
黄雪彪 , 董秀云, 周丽雅, 北京大学第三医院消化科 北京市 100083
成红燕,徐州第四医院 江苏省徐州市 221009
项目负责人:董秀云, 100083 北京市, 北京大学第三医院消化科.hdlhxb@sina.com
电话:010-62017691 -2527 传真: 010-62017700
收稿日期:2004-11-23 接受日期: 2004-12-18
摘要
, 百拇医药
目的:观察兰索拉唑对十二指肠溃疡愈合及幽门螺杆菌(Hpylori)的清除作用，并比较兰索拉唑、奥美拉唑及泰胃美对离体培养的Hpylori 生长的作用.
方法: 经胃镜检查，确诊为Hpylori 阳性的十二指肠溃疡患者65例，给予兰索拉唑30mg/次，1次/d，服药1mo，溃疡愈合后，改为15mg/次，1次/d，维持治疗3mo.服药1 mo及维持治疗3mo，复查胃镜了解十二指肠溃疡的愈合情况，胃黏膜组织学W-S染色检查Hpylori.取培养好的CAPMN66H pylori 标准菌株，涂入不同药物浓度的培养皿内，在37℃微氧环境下培养3-5d，确定兰索拉唑、奥美拉唑和泰胃美的最小抑菌浓度(MIC).
结果: 兰索拉唑治疗1 mo后，十二指肠溃疡愈合率为93.3%(56/60)，胃酸和胃蛋白酶分泌减少，与治疗前比较有明显差异(107.5±11.2 mEq/L vs43.3±3.2 mEq/L，P<0.05和910.8±194.3 mg/L vs488.2±265.0 mg/L，P<0.01).兰索拉唑治疗后Hpylori检出率下降，治疗前胃窦部 Hpylori检出率为96%，治疗1 mo后为64%，36%的患者胃窦部Hpylori已清除，胃底体部Hpylori检出率在治疗前后变化不大.给药1 mo和3mo后，胃窦部Hpylori 的感染程度明显减轻，清除的比例明显增加，治疗前为3%，治疗后1mo为36%，3mo为22%，胃底体部Hpylori的感染程度也减轻.兰索拉唑和奥美拉唑抑制离体培养的Hpylori生长，兰索拉唑MIC为12.5 mg/L，奥美拉唑是50 mg/L，泰胃美MIC>1 600mg/L.
, 百拇医药
结论: 兰索拉唑促进Hpylori阳性的十二指肠球溃疡愈合，抑制胃酸和胃蛋白酶分泌，而且能清除Hpylori，对胃窦部的作用更明显.兰索拉唑和奥美拉唑抑制离体培养的Hpylori的生长，前者作用强于后者.未观察到泰胃美有抑制Hpylori生长的作用.
黄雪彪,董秀云, 周丽雅,成红燕.兰索拉唑对十二指肠溃疡愈合、幽门螺杆菌清除和生长的作用.
世界华人消化杂志 2005;13(4):575-577
IwahiT, Satoh H, Nakao M, Iwasaki T, Yamazaki T, Kubo K, Tamura T, Imada A.Lansoprazole, a novel benzimidazole
proton pump inhibitor, and its relatedcompounds have selective activity against Helicobacter pylori.
, http://www.100md.com
AntimicrobAgents Chemother 1991;35:490-496
2 Mauch F, BodeG, Malfertheiner P. Identification and characterization of an ATPasesystem of Helicobacter pylori and
the effect of proton pumpinhibitors. Am J Gastroenterol 1993;88: 1801-1802
3 Pavicic MJ,Namavar F, Verboom T, van Winkelhoff AJ, De Graaff J. In vitrosusceptibility of Helicobacter pylori to
several antimicrobialcombinations. Antimicrob Agents Chemother 1993;37:1184-1186
, http://www.100md.com
4 Hawkey CJ, LongRG, Bardhan KD, Wormsley KG, Cochran KM, Christian J, Moules IK. Improvedsymptom relief
and duodenal ulcer healing with lansoprazole, a new protonpump inhibitor, compared with ranitidine.
Gut 1993;34:1458-1462
5 McColl KE. Helicobacterpylori infection and long term proton pump inhibitor therapy. Gut 2004;53:5-7
6 Kuipers EJ,Uyterlinde AM, Pena AS, Roosendaal R, Pals G, Nelis GF, Festen HP,Meuwissen SG. Long-term sequelae
, http://www.100md.com
of Helicobacter pylori gastritis. Lancet 1995;345:1525-1528
7 董秀云, 森治树. 辣椒煎液对胃黏膜血流量的影响和细胞保护作用. 中华消化杂志 1989;9:335-337
8 Logan RPH, Walker MM, Misiewicz JJ, Gummett PA, Karim QN, Baron JH. Changes in the intragastric distribution of
Helicobacter pylori during treatment with omeprazole. Gut 1995;36:12-16
9 Kuipers EJ, Uyterlinde AM, Pena AS, Hazenberg HJ, Bloemena E, Lindeman J, Klinkenberg-Knol EC, Meuwissen SG.
, 百拇医药
Increase of Helicobacter pylori-associated corpus gastritis during acid suppressive therapy: implications for
long-term safety. Am J Gastroenterol 1995;90:1401-1406
10 Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ, Phillips M, Waters TE, Sanderson CR.
Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet
, 百拇医药
1988;2:1437-1442
11 Kuipers EJ, Nelis GF, Klinkenberg-Knol EC, Snel P, Goldfain D, Kolkman JJ, Festen HP, Dent J, Zeitoun P, Havu N,Lamm M, Walan A. Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term
omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial.
Gut 2004;53:12-20
编辑 张海宁, http://www.100md.com
成红燕,徐州第四医院 江苏省徐州市 221009
项目负责人:董秀云, 100083 北京市, 北京大学第三医院消化科.hdlhxb@sina.com
电话:010-62017691 -2527 传真: 010-62017700
收稿日期:2004-11-23 接受日期: 2004-12-18
摘要
, 百拇医药
目的:观察兰索拉唑对十二指肠溃疡愈合及幽门螺杆菌(Hpylori)的清除作用，并比较兰索拉唑、奥美拉唑及泰胃美对离体培养的Hpylori 生长的作用.
方法: 经胃镜检查，确诊为Hpylori 阳性的十二指肠溃疡患者65例，给予兰索拉唑30mg/次，1次/d，服药1mo，溃疡愈合后，改为15mg/次，1次/d，维持治疗3mo.服药1 mo及维持治疗3mo，复查胃镜了解十二指肠溃疡的愈合情况，胃黏膜组织学W-S染色检查Hpylori.取培养好的CAPMN66H pylori 标准菌株，涂入不同药物浓度的培养皿内，在37℃微氧环境下培养3-5d，确定兰索拉唑、奥美拉唑和泰胃美的最小抑菌浓度(MIC).
结果: 兰索拉唑治疗1 mo后，十二指肠溃疡愈合率为93.3%(56/60)，胃酸和胃蛋白酶分泌减少，与治疗前比较有明显差异(107.5±11.2 mEq/L vs43.3±3.2 mEq/L，P<0.05和910.8±194.3 mg/L vs488.2±265.0 mg/L，P<0.01).兰索拉唑治疗后Hpylori检出率下降，治疗前胃窦部 Hpylori检出率为96%，治疗1 mo后为64%，36%的患者胃窦部Hpylori已清除，胃底体部Hpylori检出率在治疗前后变化不大.给药1 mo和3mo后，胃窦部Hpylori 的感染程度明显减轻，清除的比例明显增加，治疗前为3%，治疗后1mo为36%，3mo为22%，胃底体部Hpylori的感染程度也减轻.兰索拉唑和奥美拉唑抑制离体培养的Hpylori生长，兰索拉唑MIC为12.5 mg/L，奥美拉唑是50 mg/L，泰胃美MIC>1 600mg/L.
, 百拇医药
结论: 兰索拉唑促进Hpylori阳性的十二指肠球溃疡愈合，抑制胃酸和胃蛋白酶分泌，而且能清除Hpylori，对胃窦部的作用更明显.兰索拉唑和奥美拉唑抑制离体培养的Hpylori的生长，前者作用强于后者.未观察到泰胃美有抑制Hpylori生长的作用.
黄雪彪,董秀云, 周丽雅,成红燕.兰索拉唑对十二指肠溃疡愈合、幽门螺杆菌清除和生长的作用.
世界华人消化杂志 2005;13(4):575-577
IwahiT, Satoh H, Nakao M, Iwasaki T, Yamazaki T, Kubo K, Tamura T, Imada A.Lansoprazole, a novel benzimidazole
proton pump inhibitor, and its relatedcompounds have selective activity against Helicobacter pylori.
, http://www.100md.com
AntimicrobAgents Chemother 1991;35:490-496
2 Mauch F, BodeG, Malfertheiner P. Identification and characterization of an ATPasesystem of Helicobacter pylori and
the effect of proton pumpinhibitors. Am J Gastroenterol 1993;88: 1801-1802
3 Pavicic MJ,Namavar F, Verboom T, van Winkelhoff AJ, De Graaff J. In vitrosusceptibility of Helicobacter pylori to
several antimicrobialcombinations. Antimicrob Agents Chemother 1993;37:1184-1186
, http://www.100md.com
4 Hawkey CJ, LongRG, Bardhan KD, Wormsley KG, Cochran KM, Christian J, Moules IK. Improvedsymptom relief
and duodenal ulcer healing with lansoprazole, a new protonpump inhibitor, compared with ranitidine.
Gut 1993;34:1458-1462
5 McColl KE. Helicobacterpylori infection and long term proton pump inhibitor therapy. Gut 2004;53:5-7
6 Kuipers EJ,Uyterlinde AM, Pena AS, Roosendaal R, Pals G, Nelis GF, Festen HP,Meuwissen SG. Long-term sequelae
, http://www.100md.com
of Helicobacter pylori gastritis. Lancet 1995;345:1525-1528
7 董秀云, 森治树. 辣椒煎液对胃黏膜血流量的影响和细胞保护作用. 中华消化杂志 1989;9:335-337
8 Logan RPH, Walker MM, Misiewicz JJ, Gummett PA, Karim QN, Baron JH. Changes in the intragastric distribution of
Helicobacter pylori during treatment with omeprazole. Gut 1995;36:12-16
9 Kuipers EJ, Uyterlinde AM, Pena AS, Hazenberg HJ, Bloemena E, Lindeman J, Klinkenberg-Knol EC, Meuwissen SG.
, 百拇医药
Increase of Helicobacter pylori-associated corpus gastritis during acid suppressive therapy: implications for
long-term safety. Am J Gastroenterol 1995;90:1401-1406
10 Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ, Phillips M, Waters TE, Sanderson CR.
Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet
, 百拇医药
1988;2:1437-1442
11 Kuipers EJ, Nelis GF, Klinkenberg-Knol EC, Snel P, Goldfain D, Kolkman JJ, Festen HP, Dent J, Zeitoun P, Havu N,Lamm M, Walan A. Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term
omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial.
Gut 2004;53:12-20
编辑 张海宁, http://www.100md.com
