甲氰脒胍治疗慢性肝病并消化性溃疡

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一般认为消化性溃疡的发生系损害因素与防卫因素平衡失调所致,但并有慢性肝病与无肝病的消化性溃疡,包括病因在内两者是否有不同,目前尚无定论。甲氰咪胍对消化性溃疡有较高疗效,该药对肝血流量的影响已有报道,但对并有肝病的消化性溃疡治疗情况却了解甚少。为此,作者随机选取21例并有慢性肝炎或肝硬化的胃、十二指肠溃疡(以下简称肝病组)及25侧无肝病的胃、十二指肠溃疡病例(以下简称无肝病组)为研究对象,探讨两组患者的临床表现及甲氰咪胍疗效。消化性溃疡均经胃镜确诊,不包括穿透性溃疡及吻合口溃疡病例。慢性肝炎经病理确诊,部分肝硬化病例经腹腔镜或肝脏影像确诊。两组病人每日以甲氰咪胍800mg 分4次口服,4周后行胃镜复查,按崎田胃镜分期评定疗效,并对甲氰脒胍治疗前后血清白蛋白、GOT、γ—GTP 及 BUN 进行对比。治疗中测定血中胃泌素值。两组病例均以男性为多(肝病组14例,无肝病组18例)。肝病组平均年龄比无肝病组高8岁,但无统计学意义。肝病组慢性肝炎6例,肝硬化15例,其中食道静脉曲张12例。HBs 抗原阳性4例,HBs 抗体阳性5 Generally believed that the occurrence of peptic ulcer damage factors and defensive balance caused by imbalance, but with chronic liver disease and no peptic ulcer disease, including the cause of the two whether there are differences, it is not conclusive. Cimetidine has a high efficacy on peptic ulcer disease. The effect of this drug on liver blood flow has been reported, but little is known about the treatment of peptic ulcer with liver disease. To this end, the authors randomly selected 21 cases of chronic hepatitis or cirrhosis of the stomach, duodenal ulcer (hereinafter referred to as liver disease group) and 25 non-liver disease stomach, duodenal ulcer cases (hereinafter referred to as liver disease group) To investigate the clinical manifestations and the efficacy of cimetidine in two groups of patients. Peptic ulcer were diagnosed by gastroscopy, does not include penetrating ulcers and anastomotic ulcer cases. Chronic hepatitis confirmed by pathology, some cases of cirrhosis confirmed by laparoscopic or liver imaging. Two groups of patients were treated with cimetidine 800mg daily for four times orally. Four weeks later, they were examined by endoscopy. The therapeutic effect was evaluated by gastroscopy stage and serum albumin, GOT, γ-GTP and BUN were compared before and after treatment with ceftazidime. Determination of blood gastrin value during treatment. Two groups of patients were more men (liver disease group of 14 cases, no liver disease group of 18 cases). The average age of liver disease group than in non-liver disease group was 8 years old, but not statistically significant. Hepatic disease in 6 cases of chronic hepatitis, liver cirrhosis in 15 cases, of which 12 cases of esophageal varices. HBs antigen positive in 4 cases, HBs antibody positive 5
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