科研之友
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摘要
Reasons for performing the study Studies on omeprazole have reported that doses as low as 0.7mg/kg bwt per os are potent suppressors of acid production. Yet, to date, no studies have compared treatment efficacy of different doses in clinical cases of equine gastric ulceration. Furthermore, no studies have been performed to compare the healing response of the squamous and glandular mucosa to acid suppression therapy. Objectives To compare: 1) the efficacy of 2 doses of omeprazole in the treatment of primary squamous and glandular gastric ulceration; and 2) the healing response of primary squamous and glandular gastric ulceration to acid suppression therapy. Study design A blinded, randomised, dose-response clinical trial. Methods Twenty Thoroughbred racehorses with grade 2/4 glandular ulceration were identified on gastroscopy. Seventeen horses also had grade 2/4 squamous ulceration. Horses were randomly assigned to one of 2 groups. Horses received either 2.0g (high dose: 4.0mg/kg bwt) or 0.8g (low dose: 1.6mg/kg bwt) of oral omeprazole per os once daily. Gastroscopy was repeated at 28-35 days. Results Time and dose significantly affected grades of squamous (P<0.0001, P = 0.02) and glandular (P = 0.006 and 0.005) ulceration. Data analysis did not support our hypothesis that the lower dose would have similar effects (i.e. be noninferior) to the higher dose when considering ulcer healing and ulcer improvement. Improvement was more likely with the high dose for the squamous (P = 0.05) but not glandular (P = 0.4) mucosa. The percentage of glandular ulcers that improved was less than squamous ulcers (P = 0.02). Conclusions The results suggest that a dose-response exists for the treatment of both squamous and glandular ulcers. Improvement of glandular ulcers was not as complete as observed with squamous ulcers and current equine gastric ulcer syndrome treatment recommendations may not be appropriate for glandular disease.
- 出版日期2014-7
