CIMETIDINE, CIGARETTE-SMOKING, AND RECURRENCE OF DUODENAL-ULCER
CIMETIDINE, CIGARETTE-SMOKING, AND RECURRENCE OF DUODENAL-ULCER
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DOI：
10.1056/nejm198409133111101
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
OPEKUN, A
中科院分区：
文献类型：
--
作者：
SONTAG, S;GRAHAM, DY;OPEKUN, A
370例近期治愈的十二指肠溃疡患者参加了一项为期1年的双盲随机多中心试验，比较安慰剂与3种不同剂量的西咪替丁（200 mg每日2次，300 mg每日2次和睡前400 mg）预防十二指肠溃疡复发。到1年结束时，内窥镜检查显示，接受3种剂量西咪替丁的患者的累积症状复发率相似（分别为19%、15%和13%;不显着），而安慰剂治疗组的症状复发率为34.7%（与每个西咪替丁组相比，P < 0.01）。吸烟是一个重要的变量;在安慰剂接受者中，吸烟者溃疡复发的可能性（72%）显著高于非吸烟者（21%，P < 0.001）。西咪替丁治疗后吸烟者溃疡复发率显著降低（从72%降至34%，P < 0.01）。接受西咪替丁的吸烟者与接受安慰剂的非吸烟者复发的可能性至少相同（34%对21%，不显著）。吸烟似乎是十二指肠溃疡复发的一个主要因素，对于吸烟者，戒烟在预防溃疡复发方面可能比使用西咪替丁更重要。
Patients (370) with recently healed duodenal ulcer entered into a 1 yr, doubleblind, randomized multicenter trial comparing placebo with 3 different dose schedules of cimetidine (200 mg twice a day, 300 mg twice a day and 400 mg at bedtime) for the prevention of recurrent duodenal ulcer. By the end of 1 yr, the cumulative symptomatic recurrence rate as demonstrated by endoscopy was similar for the patients receiving the 3 dosages of cimetidine (19%, 15 and 13%, respectively; not significant), whereas the placebo-treated group had a 34.7% symptomatic recurrence rate (P < 0.01 as compared with each cimetidine group). Cigarette smoking was an important variable; among the placebo recipients ulcer recurrence was significantly more likely in smokers (72%) than in nonsmokers (21%, P < 0.001). The frequency of ulcer recurrence in smokers was significantly reduced by treatment with cimetidine (from 72 to 34%, P < 0.01). Smokers who received cimetidine were at least as likely to have a recurrence as were nonsmokers who received placebo (34 vs. 21%, not significant). Smoking appears to be a major factor in recurrence of duodenal ulcer, and in smokers, giving up smoking may be more important in the prevention of ulcer recurrences than administration of cimetidine.