摘要
目的:探讨非甾体类抗炎药物(NSAIDs)所致上消化道出血近期及远期发生率的大小关系。方法:选择共316例因基础疾病后开始长期使用NSAIDs的患者。第一阶段:将患者随机分为四个小组,其中,PPI组(80例)给予服用雷贝拉唑10mg,2次/天,口服;黏膜保护剂组(80例)给予服用瑞巴派特100mg,3次/天,口服;综合组(78例)给予服用雷贝拉唑10mg,2次/天+瑞巴派特片100mg,3次/天,口服,对照组(78例)不加雷贝拉唑和瑞巴派特,全部疗程为8周,治疗期间及出现上消化道出血的患者立即行胃镜检查,证明是胃、十二指肠球溃疡和(或)糜烂,并排除其他可能原因(如肿瘤等)。观测四组在开始使用NSAIDs药物的近期及并发上消化道出血的发生率。第二阶段:排除以上各组中近期即有上消化道出血的患者,并继续以原来的治疗方案用药,疗程继续维持1年。最终观察各组远期上消化道的出血率。结果:(1)近期上消化道出血率比较:PPI组和黏膜保护剂组各有4例(5%),综合组有2例(2.6%)发生上消化道出血,此三组之间通过相互比较,发现差异无统计学意义(即P>0.05);对照组有14例(17.9%)发生上消化道出血,经统计学分析,与上述三组之间的差异均存在统计学意义(及P<0.05)。(2)远期上消化道出血率比较:PPI组和黏膜保护剂组各有4例,对照组有2例,综合组有6例脱落。PPI组有6例(8.3%)发生上消化道出血,黏膜保护剂组有8例(11.8%)发生上消化道出血,综合组有6例(8.6%)发生上消化道出血,但是三组之间相互比较,发现差异无统计学意义(及P>0.05);对照组有32例(51.6%)发生上消化道出血,与以上三组之间相互比较,差异均存在统计学意义(及P<0.01)。结论:在大部分长期服用非甾体类抗炎药的患者中,PPI与瑞巴派特能够预防NSAIDs所致的上消化道出血,并且不管单独应用还是联合应用,在减低上消化道出血的近期和远期发生率上的效果是一样的。
Objective：To explore the non-steroidal anti-inflammatory drug（NSAIDs） of upper gastrointestinal hemorrhage caused by short-term and long-term incidence relation.Methods：a total of 316 cases with basic disease after long-term use of NSAIDs patients.The first stage：the patients were randomly divided into four groups,group PPI（n=80） given ray Bella met 10 mg,2 times/day,oral mucosal protective agent;group（n=80） given rebamipide 100 mg,3 times/day,oral;integrated group（n=78） given the thunder Bella met 10 mg,2 times/day ＋ rebamipide 100 mg,3 times/day,oral,and control group（78 cases） not Garet Bella met and rebamipide,all treatment for 8 weeks,during treatment and upper gastrointestinal bleeding patients with immediate gastroscopy,proved to be a gastric,duodenal ulcer and（or） and exclude other possible causes of erosion（such as tumor etc.）.Observation of four groups at the beginning of NSAIDs drugs recently and complicated with upper gastrointestinal bleeding incidence.The second stage：exclusion of all groups in the near future with upper gastrointestinal bleeding in patients,and continue to be the original drug treatment program,course to maintain 1 years.The final observed long-term upper gastrointestinal bleeding rate.Results：（1） in the upper gastrointestinal tract bleeding rate：PPI group and mucosal protective agent group were 4 cases（5%）,comprehensive group consisted of 2 patients（2.6%） incidence of upper gastrointestinal bleeding,the three groups by mutual comparison between found no statistically significant difference（P0.05）;while in the control group 14（17.9%） cases of upper gastrointestinal bleeding occurred,the statistical analysis and the differences between the three groups were statistically significant（and P0.05）.（2） longterm upper gastrointestinal bleeding rate：PPI group and mucosal protective agent group each with 4 cases,control group 2 cases,comprehensive group has 6 cases to fall off.6 cases in group PPI（8.3%） occurrence o
出处
《求医问药（下半月刊）》
2012年第10期380-381,共2页
Seek Medical and Ask The Medicine
关键词
非甾体类抗炎药
上消化道出血
发生率
non-steroidal anti-inflammatory drugs
upper gastrointestinal bleeding
incidence rate
