CAJ | 학술논문

目的比较抑酸药H2受体拮抗剂(H2A)与质子泵抑制剂(PPI)对消化性溃疡出血的疗效. 方法①30只SD大鼠随机分成6组，制备急性胃溃疡出血模型，以不同pH值的缓冲液冲洗胃溃疡部位后记录其胃粘膜出血时间(GMBT). ②24例消化性溃疡急性出血患者，随机分2组，24 h内洛赛克组静滴40 mg洛赛克，法莫替丁组静滴40 mg法莫替丁，动态测定给药前1 h及给药后24 h胃内pH值. ③回顾性分析272例应用洛赛克(40 mg静滴，1次*d-1)与270例应用法莫替丁(40 mg静滴，2次*d-1)的消化性溃疡出血患者手术率与死亡率. 结果当pH≥6.0时大鼠GMBT明显缩短(P<0.05). 胃内pH值监测结果，用药后各组pH>4.0, pH>6.0的时间，洛赛克组比法莫替丁组显著延长(P<0.01). 洛赛克治疗组手术率比法莫替丁治疗组明显减低(P<0.05)，而死亡率无显著差异. 结论对急性消化性溃疡出血，质子泵抑制剂的抑酸止血效果明显高于H2受体拮抗剂.
목적비교억산약H2수체길항제(H2A)여질자빙억제제(PPI)대소화성궤양출혈적료효. 방법①30지SD대서수궤분성6조，제비급성위궤양출혈모형，이불동pH치적완충액충세위궤양부위후기록기위점막출혈시간(GMBT). ②24례소화성궤양급성출혈환자，수궤분2조，24 h내락새극조정적40 mg락새극，법막체정조정적40 mg법막체정，동태측정급약전1 h급급약후24 h위내pH치. ③회고성분석272례응용락새극(40 mg정적，1차*d-1)여270례응용법막체정(40 mg정적，2차*d-1)적소화성궤양출혈환자수술솔여사망솔. 결과당pH≥6.0시대서GMBT명현축단(P<0.05). 위내pH치감측결과，용약후각조pH>4.0, pH>6.0적시간，락새극조비법막체정조현저연장(P<0.01). 락새극치료조수술솔비법막체정치료조명현감저(P<0.05)，이사망솔무현저차이. 결론대급성소화성궤양출혈，질자빙억제제적억산지혈효과명현고우H2수체길항제.
AIM　To investigate therapeutic effects of H2-receptor antagonists (H2A) and proton-pump inhibitors (PPI) on peptic uleer bleeding. METHODS　Thirty SD rats were randomly divided into 6 groups after gastric mucosal ulcer models were reproduced. The gastric mucosal bleeding time (GMBT) of the 5 groups was measured after the perfusion of ulcer site with pH 3.0, 4.0, 5.0, 6.0 and 7.0 buffer solution, respectively. Twenty four patients with peptic ulcer hemorrhage were randomly divided into 2 groups: during 24 hours, Losec one group received intravenous instillation of 40 mg Losec; Famotidine group 40 mg Famotidine. In each group, 24-hour intragastric pH was dynamically measured. In a retrospective study, the operation rate and mortality of bleeding gastric-duodenal ulcer were compared between 272 patients (40 mg Famotidine intraveneously administered once daily) and 270 ones (40 mg Gaster intraveneously administered twice daily). RESULTS　GMBT became significantly shorter with buffer solution at pH 6.0 or more than that at pH less than 6.0 (P<0.05). The time when intragastric pH was over 4.0 or 6.0 in Losec one, was significantly longer than that in Famotidine ones, and the operation rate of bleeding gastrointestinal ulcer patients treated with Losec was statistically lower than that with Famotidine (P<0.05). CONCLUSION　Proton-pump inhibitors have stronger anti-acid-secretory and therapeutic effects on gastrointestinal ulcer bleeding than H-receptor antagonists.