目的探讨注射用尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血的临床疗效。方法选取驻马店市中心医院2014年1月—2016年8月收治的上消化道出血患者80例,随机分为对照组和治疗组,每组各40例。对照组患者静脉泵注注射用生长抑...目的探讨注射用尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血的临床疗效。方法选取驻马店市中心医院2014年1月—2016年8月收治的上消化道出血患者80例,随机分为对照组和治疗组,每组各40例。对照组患者静脉泵注注射用生长抑素,3 mg加入生理盐水500 m L中,泵入速度40 m L/h,2次/d;同时静脉滴注注射用埃索美拉唑钠,40 mg加入生理盐水100 m L中,30 min内滴完,2次/d。治疗组患者在对照组的基础上静脉推注注射用尖吻蝮蛇血凝酶,1 U溶于20 m L生理盐水中,1次/d。两组均连续治疗5 d。比较两组患者治疗前后临床疗效、输血量、止血时间、血红蛋白(Hb)水平、凝血指标及再出血率。结果治疗后,对照组的总有效率为80.00%,显著低于治疗组的95.00%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,治疗组患者输血量与止血时间均少于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组Hb水平均显著升高(P<0.05);且治疗组的Hb水平高于对照组(P<0.05)。治疗后,两组PT、APTT均显著缩短,同组治疗前后比较差异有统计学意义(P<0.05);且治疗后治疗组PT、APTT均短于对照组,两组比较差异具有统计学意义(P<0.05)。结论注射用尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血可有效缩短止血时间、减少输血量,且利于血红蛋白水平的恢复,具有一定的临床推广应用价值。展开更多
Summary： To investigate the effect of preceding naloxone injection into the third cerebroventricle or acute subdiaphragmatic vagotomy on the gastric acid secretion inhibited by the somatostatin analogue octreotide gi...Summary： To investigate the effect of preceding naloxone injection into the third cerebroventricle or acute subdiaphragmatic vagotomy on the gastric acid secretion inhibited by the somatostatin analogue octreotide given by intracerebroventricular （icv） injection. The third ventricles were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later, acute gastric lumen perfusion was carried out. The gastric perfusion samples were collected every 10 min and were titrated by 0.01 mol/L NaOH to neuter. On the basis of subcutaneous injection of pentagastrin （G-5, 160 g/kg）, icv injection of physiological saline （group A, n=20）, icv injection of octreotide （0.05 μ g） （group B, n=20）, icv injection of naloxone （2.5 μ g）＋octreotide （0.05 μg） （group C, n=20）, acute subdiaphragmatic vagotomy＋ icv injection of physiological saline （group D, n=20）, or acute subdia- phragrnatic vagotomy＋icv injection of octreotide （0.05 μg） （group E, n=20） were conducted. Before and after icv injection, 1-h total acid output （TAO） was determined and compared. The experimental data were expressed in change rate （%） of TAO. The change rates （%） of TAO were 4.60 % in group A, -20.35 % in group B, - 18.06 % in group C, 5.01% in group D and -21.59 % in group E, respectively. Comparison of group B or C versus group A showed that P〈0.01 and comparison between the group E versus group D showed that P〈0.01. Whereas the differences between group C and group B, group E and group B were not statistically significant （P〉0.05 for all）. The results indicate that the central inhibition of gastric acid secretion by octreotide may not be mediated by the endogenous opi- ate substance or its receptor and the peripheral pathway for icv injection of octreotide to suppress gastric acid secretion is via extra-vagus route.展开更多
文摘目的探讨注射用尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血的临床疗效。方法选取驻马店市中心医院2014年1月—2016年8月收治的上消化道出血患者80例,随机分为对照组和治疗组,每组各40例。对照组患者静脉泵注注射用生长抑素,3 mg加入生理盐水500 m L中,泵入速度40 m L/h,2次/d;同时静脉滴注注射用埃索美拉唑钠,40 mg加入生理盐水100 m L中,30 min内滴完,2次/d。治疗组患者在对照组的基础上静脉推注注射用尖吻蝮蛇血凝酶,1 U溶于20 m L生理盐水中,1次/d。两组均连续治疗5 d。比较两组患者治疗前后临床疗效、输血量、止血时间、血红蛋白(Hb)水平、凝血指标及再出血率。结果治疗后,对照组的总有效率为80.00%,显著低于治疗组的95.00%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,治疗组患者输血量与止血时间均少于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组Hb水平均显著升高(P<0.05);且治疗组的Hb水平高于对照组(P<0.05)。治疗后,两组PT、APTT均显著缩短,同组治疗前后比较差异有统计学意义(P<0.05);且治疗后治疗组PT、APTT均短于对照组,两组比较差异具有统计学意义(P<0.05)。结论注射用尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血可有效缩短止血时间、减少输血量,且利于血红蛋白水平的恢复,具有一定的临床推广应用价值。
基金This work was supported by Returning Overseas Scholar Science Study Foundation, the Education Ministry of China (No. 2005383)
文摘Summary： To investigate the effect of preceding naloxone injection into the third cerebroventricle or acute subdiaphragmatic vagotomy on the gastric acid secretion inhibited by the somatostatin analogue octreotide given by intracerebroventricular （icv） injection. The third ventricles were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later, acute gastric lumen perfusion was carried out. The gastric perfusion samples were collected every 10 min and were titrated by 0.01 mol/L NaOH to neuter. On the basis of subcutaneous injection of pentagastrin （G-5, 160 g/kg）, icv injection of physiological saline （group A, n=20）, icv injection of octreotide （0.05 μ g） （group B, n=20）, icv injection of naloxone （2.5 μ g）＋octreotide （0.05 μg） （group C, n=20）, acute subdiaphragmatic vagotomy＋ icv injection of physiological saline （group D, n=20）, or acute subdia- phragrnatic vagotomy＋icv injection of octreotide （0.05 μg） （group E, n=20） were conducted. Before and after icv injection, 1-h total acid output （TAO） was determined and compared. The experimental data were expressed in change rate （%） of TAO. The change rates （%） of TAO were 4.60 % in group A, -20.35 % in group B, - 18.06 % in group C, 5.01% in group D and -21.59 % in group E, respectively. Comparison of group B or C versus group A showed that P〈0.01 and comparison between the group E versus group D showed that P〈0.01. Whereas the differences between group C and group B, group E and group B were not statistically significant （P〉0.05 for all）. The results indicate that the central inhibition of gastric acid secretion by octreotide may not be mediated by the endogenous opi- ate substance or its receptor and the peripheral pathway for icv injection of octreotide to suppress gastric acid secretion is via extra-vagus route.
