| OBJECTIVE:To investigate the PPI maintenance therapy to prevent recurrence of peptic ulcer effect and influence on serum vitamin B12 levels.METHODS:Select the fujian provincial hospital gastroenterology outpatient and inpatient treatment, confirmed by endoscopy 60 patients with active peptic ulcer, Hp-positive patients with sequential therapy Hp eradication therapy, after giving Rabeprazole 20mg, qd × 4 weeks,the ulcer healing scar up period 58 patients agreed to accept the maintenance treatment of 40 cases were randomly divided into two treatment groups. Group A:Rabeprazole 10mg, qd, for 12 months; Group B:placebo 10mg, qd, for 12 months. Before treatment,4 weeks, 6 and 12 months of maintenance therapy and endoscopy were observed at the end of ulcer recurrence, and detecting changes in serum vitamin B12 levels.RESULTS:1.Helicobacter pylori (Hp) treatment:60 patients had 40 cases of Hp-positive patients underwent sequential therapy of anti-Hp therapy,38 patients were treated review Hp-negative (Hp eradication rate of 95%),2 cases after treatment review of anti-Hp Hp remain positive.2. Peptic ulcer cure cases:Helicobacter pylori (Hp) infection who were Hp eradication after treatment, four weeks after the treatment of peptic ulcer, ulcer healing after a total of 58 cases of endoscopy, the healing rate was 96.7%, the total effective rate was 100% of ulcers.3. After six months of treatment to maintain, A group relapse rate (10%) was significantly lower than group B (75%) (P<0.05)4. A group before treatment, after 4 weeks of treatment, maintenance treatment was no significant difference (P> 0.05) between subgroups among VitB12 level six months after. But 12 months of maintenance therapy VitB12 levels lower than before treatment, after 4 weeks of treatment, the treatment VitB12 level six months after (P<0.05). Group B before treatment, four weeks later,6-month and 12-month serum VitB12 contents were (400.98± 94.53) pg/ml, (401.65±95.43) pg/ml, (399.95±91.08) pg/ml and (410.83±91.52) pg/ ml, among subgroups VitB12 levels were not significantly different (P> 0.05). A, B groups in the grouping variable effects ANOVA shows F=0.605, P= 0.442, A, B two groups showed no significant difference (P>0.05).5 A group of 11 cases of male patients before treatment, four weeks after maintenance therapy was no significant difference (P> 0.05) between 6 months and 12 months after the serum levels of each subgroup VitB12, but 12 months of maintenance therapy VitB12 level lower than before treatment, after 4 weeks of treatment, the treatment VitB12 level six months after (P<0.05). Nine cases of female patients before treatment, four weeks later, maintenance therapy is also no significant difference between 6 months and 12 months after the serum levels of VitB12 subgroup (P> 0.05), the treatment of 12 months VitB12 levels lower than before treatment, after four weeks of treatment, the treatment VitB12 level six months after (P<0.05).CONCLUTION:1. Long-term follow-up of patients after 1 year PPIs found little impact on serum vitamin B12 levels, the first six months of steady trend, but in the first 12 months after administration of a downward trend.2. Preventive maintenance treatment with antacids, which can effectively reduce ulcer recurrence.3. Sequential therapy H. Pylori positive peptic ulcer has higher H. Pylori eradication rate and ulcer healing rate. |
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