不同剂量泮托拉唑对消化性溃疡并出血高危患者胃内pH的影响  

Effect of different doses of pantoprazole on intra-gastric pH in patients with a high risk of peptic ulcer bleeding

作　　者：翟丽华[1,2] 王启仪[3] 沙卫红[3] 布小玲[3] 岑荣英[3] 李子俊[3] 刘婉薇[3] 

机构地区：[1]汕头大学医学院 [2]广东省人民医院 广东省医学科学院,汕头515041 [3]广东省人民医院广东省医学科学院消化内科,广州510080

出　　处：《新医学》2015年第4期254-258,共5页Journal of New Medicine

摘　　要：目的比较不同剂量泮托拉唑对消化性溃疡并出血(PUB)高危患者胃内pH值的影响。方法 19例经胃镜确诊为PUB的患者(Forrest分级Ib-Ⅱb)分为2组,分别予静脉使用大剂量泮托拉唑(首剂80 mg静脉注射,然后以8 mg/h的速度持续静脉注射)和常规剂量泮托拉唑(首剂40 mg静脉注射,然后以4 mg/h的速度持续静脉注射)治疗,并对其进行24 h动态胃酸监测。其中,大剂量组8例,常规剂量组11例。观察2组患者24 h胃内pH达到6.0的时间,并比较其pH>6.0占总监测时间百分比。结果 2组患者一般情况(包括年龄、性别、幽门螺杆菌感染情况、溃疡类型、内镜分级等)比较差异均无统计学意义。大剂量组患者胃内p H达到6.0时间为(30.50±4.84)min,常规剂量组为(57.09±13.56)min,2组比较差异有统计学意义(P<0.01)。大剂量组患者胃内p H>6.0所占时间百分比为95.42%(44.36%),常规剂量组为42.15%(40.14%),2组比较差异有统计学意义(P=0.006)。结论大剂量和常规剂量静脉使用泮托拉唑均能使PUB高危患者胃内p H值达到6.0以上,但大剂量组起效更快且持续时间更长。Objective To evaluate the effect of different doses of pantoprazole on intra-gastric pH in patients with a high risk of peptic ulcer bleeding （PUB）.Methods Nineteen patients diagnosed with PUB （Forrest grading：Ib-IIb）by gastroscope were divided into the high-（n =8）and regular-dose groups（n =11）.In the high dose group,eight patients were intravenously administered with pantoprazole （80 mg bolus and then continuous infusion at speed of 8 mg/h）and 11 in the regular dose group were delivered with intravenous injec-tion of pantoprazole （40 mg bolus and then continuous infusion at a speed of 4 mg/h）.Intra-gastric pH in all patients was monitored for 24 h.The mean time when the intra-gastric pH reached 6.0 （within 24 h）and the percentage of patients with intra-gastric pH 〉6.0 were observed.Results The general data including age, gender,helicobacter pylori infection,type of ulcer and endoscopic classification,etc.did not significantly dif-fer between two groups （all P 〉0.05）.The mean time when intra-gastric pH reached 6.0 was approximately （30.50 ±4.84）min in the high dose group,which was significantly shorter than （57.09 ±13.56）min in the regular dose group （P 〈0.01）.The percentage of patients with intra-gastric pH 〉6.0 in the high dose group was 95.42% （44.36%）,significantly higher compared with 42.15% （40.14%）in the regular dose group （P =0.006）.Conclusions Intravenous administration of pantoprazole at a high and regular dose can both in-crease intra-gastric pH to above 6 in patients with a high risk of PUB,whereas a high dose of pantoprazole yields faster and longer effect compared with a regular dosage.

关 键 词：消化性溃疡出血 泮托拉唑 胃内PH 

分 类 号：R573.1[医药卫生—消化系统]