Influence of Helicobacter pylori infection and cetraxate on gastric mucosal blood flow during healing of endoscopic mucosal resection-induced ulcers.
OBJECTIVE
Helicobacter pylori (H. pylori) infection is known to affect the gastric microcirculation, and cetraxate is reported to accelerate gastric ulcer healing, possibly by augmenting gastric mucosal blood flow (MBF). The aim of this study is to clarify the effect of H. pylori infection and cetraxate on MBF during gastric ulcer healing.


METHODS
Forty-two patients who had undergone endoscopic mucosal resection (EMR) were studied. Mucosal blood flow was measured by the use of a laser Doppler flowmeter in the surrounding mucosa and at the ulcer margin, before, 1 day, 1 week and 4 weeks after EMR. Helicobacter pylori infection was confirmed by the use of bacterial culture and histology. After EMR, patients were randomly assigned to receive 30 mg lansoprazole (u.i.d; L-regimen) or 30 mg lansoprazole (u.i.d.) with 200 mg cetraxate (q.i.d; LC-regimen) for 4 weeks.


RESULTS
The MBF ratio (MBF at ulcer margin/MBF in surrounding mucosa) 1 week after EMR was significantly lower than that before or 4 weeks after EMR only in H. pylori-positive patients treated with the L-regimen. No such decrease in MBF was observed after 1 week in H. pylori-positive patients treated with the LC-regimen or in H. pylori-negative patients.


CONCLUSIONS
A transient decrease in MBF was detected at the ulcer margin during healing of EMR-induced ulcers in H. pylori-infected patients. Cetraxate seemed to prevent this decrease in MBF.
Adachi
K
K
Department of Internal Medicine II, Shimane Medical University, Izumo, Shimane, Japan. kadachi@shimane-med.ac.jp
Suetsugu
H
H
Moriyama
N
N
Kazumori
H
H
Kawamura
A
A
Fujishiro
H
H
Sato
H
H
Okuyama
T
T
Ishihara
S
S
Watanabe
M
M
Kinoshita
Y
Y
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply* / Q000187:drug effects / Q000382:microbiology; D005773:Gastroscopy / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D013276:Stomach Ulcer / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology; D014148:Tranexamic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; C000665:cetraxate; D014148:Tranexamic Acid; D009853:Omeprazole