摘要
目的探讨抑酸药H2受体拮抗剂与质子泵抑制剂（PPI）对消化性溃疡并出血的疗效。方法（1）用不同pH值的缓冲液冲洗大白鼠胃内活检伤口，测定其胃粘膜出血时间（GMBT）；（2）连续48小时监测胃内pH值；（3）回颀性分析303例应用雷尼替了与326例应用奥美拉唑的消化性溃疡并出血病人手术率与死亡率。结果（1）体外动物实验结果显示当pH≥6时，其GMBT明显减少，约57．6±18．6秒。（2）胃内pH值监测结果，西咪替丁1600mg静脉注射与奥美拉唑40mg静脉注射，胃内pH值相仿，分别为5．4±1．3和5．8土1．3，逐步降低西咪替丁用量，其pH值亦逐步下降，至常规剂量800mg时，胃内pH值为1．5，基本无作用。（3）临床疗效观察，303例雷尼替丁与326例奥美拉唑组的消化性溃疡并出血者手术率与死亡率，前者分别为7．28％和1．99％，后者分别为4．91％和1．84％。结论质子泵抑制剂奥美拉唑静脉注射的抑酸效果，适用于消化性溃疡并出血病人，其疗效优于H2受体拮抗剂。
Objective To study the effect of H2-receptor antagonists and proton-pump inhibitors on peptic ulcer bleeding. Methods Different PH buffer solutions were used to wash the mice's intragastric wound and test the gastric mucosal bleeding time (GMBT). Result (1)The GMBT decreased significintly when the pH was ≥6.0. (2)Intragastric acidity wad monitored continuously in patients with duodenal ulcer for 48 hours. When given as an intravenous infusion with, omeprazole 40mg/day it quickly inhibited the intragastric acidity, and gave consistently high pH level of 5.8±1.3. While cimetidine, given as an intravenous infusion with very high dose (1600mg/day), the pH level was 5.4±1.6. Acid secretion was inhibited similarly as omeprazole. When given 800mg/day, the pH level is 1.5, there is no acid inhibitings effect. (3)Clinical in the dosege of effectiveness. 303 peptic ulcer bleeding patients were treated by ranitidine and another 326 patients were treated by omeprazole, the mortality and operative rates here 1.84 % and 4.91 % in, omeprazole group, whereas in the group receiving ranitidine, they were 1.99 % and 7.28 %. Con'clusion Given by intravenous infusion, the acid inhibitiom by omeprazole is more effective than that by ranitdine. Omeprazole is pertinent for treatment of peptic ulcer bleeding.
出处
《中华消化杂志》
CAS
CSCD
北大核心
1998年第5期284-286,共3页
Chinese Journal of Digestion
关键词
H2受体拮抗剂
质子泵抑制剂
消化性溃疡
出血
H2-receptor antagonists Proton-pump inhibitiors Intragastric acidity Peptic ulcer Gastric mucosal bleeding time
