雷贝拉唑预防肝硬化门脉高压性胃病及肝源性溃疡致上消化道出血的疗效分析  

Efficacy and safety of rabeprazole in upper gastrointestinal bleeding of PHG and HU in patients with liver cirrhosis

作　　者：王孟仙[1] 何治军[1] 黄光明[1] 

机构地区：[1]重庆市第五人民医院消化内科,重庆400062

出　　处：《中国医药导报》2016年第18期146-148,共3页China Medical Herald

基　　金：重庆市卫生局医学科研面上基金项目(2012-2445)

摘　　要：目的评价雷贝拉唑预防肝硬化门脉高压性胃病及肝源性溃疡致上消化道出血的疗效及安全性。方法选择2012年6月～2014年4月在重庆市第五人民医院门诊部及住院部符合条件的肝硬化患者。肝硬化门脉高压性胃病（PHG）患者72例和肝源性溃疡（HU）患者90例,两组患者分别随机均分为A、B、C三亚组,PHG组中A、B、C亚组各为24例,HU组中A、B、C亚组各为30例,A亚组口服雷贝拉唑20 mg qd,B亚组口服雷贝拉唑20 mg qod,C亚组不服药,观察1年,随访指标包括临床血清学指标（血常规、肝功、肾功、凝血功能、血镁）及有无发生上消化道出血（复查胃镜明确出血病因）。结果随访到终点的患者共156例,其中PHG组69例,PHG（A）23例、PHG（B）24例、PHG（C）22例;HU组87例,HU（A）29例、HU（B）29例、HU（C）29例。无论是雷贝拉唑20 mg qd还是20 mg qod,与对照组比较,在预防肝硬化PHG和HU致上消化道出血方面均未显示出明显优势,差异无统计学意义（P〉0.05）。雷贝拉唑治疗1年,未发生常见的不良反应。结论雷贝拉唑在预防肝硬化门脉高压性胃病及肝源性溃疡致上消化道出血方面可能不是恰当的选择。Objective To assess efficacy and safety of rabeprazole in upper gastrointestinal bleeding of PHG and HU in patients with liver cirrhosis. Methods Patients with cirrhosis and endoscopic findings related to portal hypertensive gastropathy（PHG） and hepatogenic ulcer（HU） according to the inclusion criteria from June 2012 to April 2014 in the Fifth People＇s Hospital of Chongqing outpatient and inpatient were selected. 72 PHG and 90 HU patients were assigned randomly and averagely to three subgroups, 24 patients were in every subgroup of PHG, and 30 patients were in every subgroup in HU respectively, group A patients were undergone therapy（rabeprazole 20 mg, qd）, group B patients were undergone therapy（rabeprazole 20 mg, qod）, group C patients did not undergo therapy. Serological index, including routine blood test, liver function, renal function, coagulation and serum magnesium were followed up for 1 year. Meanwhile,whether upper gastrointestinal bleedings were happened in these patients or not was also studied, and gastroscoe examination was applied to diagnose the cause of bleeding. Results A total of 156 patients with follow-up to the finish line were included, PHG were found in 69 patients and HU in 87 patients, and PHG（A） 23 patients, PHG（B） 24 patients,PHG（C） 22 patients, HU（A） 29 patients, HU（B） 29 patients, HU（C） 29 patients. Compared with the control group, whether rabeprazole azole 20 mg qd or 20 mg qod did not show obvious advantage in prevention of non-variceal upper gastrointestinal bleeding in patients with liver cirrhosis, including PHG and HU, there was no statistically significant difference（P 〉0.05）. Conclusion Rabeprazole in prevention of upper gastrointestinal bleeding causing of PHG and HU in patients with liver cirrhosis may not be the right choice.

关 键 词：雷贝拉唑 肝硬化 门脉高压性胃病 肝源性溃疡 出血 预防 

分 类 号：R975[医药卫生—药品]