【摘要】 目的观察奥美拉唑（Ｏｍｅ）愈合十二指肠溃疡（Ｄｕ）对胃液表皮生长因子（ＥＧＦ）浓度的影响。方法５８例Ｈｐ阳性Ｄｕ思考随机分为三组：奥美拉唑（Ｏｍｅ）＋胶体铋剂（ＣＢＳ）＋羟氨苄青霉素（Ａｍｏ）组，雷尼替丁（Ｒａ）＋ＣＢＳ＋Ａｍｏ组和ＣＢＳ＋Ａｍｏ组，服药４周（Ｏｍｅ，Ｒａ和ＣＢＳ分别服４周，Ａｍｏ２周）。于治疗前、后分别测定空腹血清胃泌素和胃液ＥＧＦ浓度并与１２例Ｈｐ阴性健康对照组比较。结果４周溃疡愈合率三组分别为９５．５％，６８．４％和６４．７％（Ｐ＜０．０５）；Ｈｐ阴转率三组差异无显著性。治疗前Ｄｕ各组胃液ＥＧＦ浓度均显著低于对照组；治疗后Ｏｍｅ＋ＣＢＳ＋Ａｍｏ组和Ｒａ＋ＣＢＳ＋Ａｍｏ组血清胃泌素、胃液ｐＨ和ＥＧＦ均分别显著高于对照组和治疗前；Ｏｍｅ＋ＣＢＳ＋Ａｍｏ组各指标也显著高于Ｒａ＋ＣＢＳ＋Ａｍｏ组；而ＣＢＳ＋Ａｍｏ组治疗前、后无显著变化。治疗后Ｏｍｅ＋ＣＢＳ＋Ａｍｏ组和Ｒａ＋ＣＢＳ＋Ａｍｏ组血清胃泌素与胃液ＥＧＦ均呈正相关。五肽胃泌素刺激后，８例对照和１２例Ｄｕ胃液ＥＧＦ排出量均显著增加。结论抑制胃酸分泌使胃泌素分泌增多进而促使胃液ＥＧＦ释放增加，以及提高胃内ｐＨ使ＥＧＦ降解减少可能是Ｏｍｅ快速?更多还原

【Abstract】 Objective To investigate the effect of omeprazole (Ome) on epidermal growth factor (EGF) levels in gastric juice during healing of duodenal ulcer (Du). Methods 58 Du patients with Helicobacter pylori(Hp) infection were randomly divided into three groups: Ome group(Ome plus colloidal bismuth subcitrate (CBS) and amoxycillin (Amo), ranitidine (Ra) group (Ra plus CBS and Amo) and CBS group (CBS plus Amo). Serum gastrin and gastric juice EGF levels were measured by radioimmunoassay before and after 4 weeks medication and compared with 12 healthy controls. Results At the end of the treatment, the healing rate was 95.5% in Ome group, 68.4 % in Ra group and 64.7% in CBS group (P< 0.05). Before treatment, gastric juice EGF levels in Du patients of all three groups were significantly lower than that in controls. After treatment, serum gastrin, gastric pH and EGF in both Ome group and Ra group were all significantly higher than those in controls and the same group before medication. The above parameters in Ome group were also higher than in Ra group, but in CBS group before and after treatment they were not significantly different. Serum gastrin in Ome group and Ra group were positively correlated with gastric juice EGF respectively. The output of gastric juice EGF in 8 controls and 12 Du patients were all increased markdly after pentagastrin (6μ/kg, im) stimulation . Conclusion The inhibition gastric acid secretion and decrease of degradation of EGF might be the cause of enhanced serum gastrin which might mediate the release of EGF in gastric juice and this contributes to the rapid healing of the ulcer after treatment by omeprazole. [更多还原