乌司他丁在上消化道溃疡合并出血患儿治疗中的疗效观察  

Efficacy and safety of ulinastatin for treatment of upper gastrointestinal ulcer complicated with hemorrhage in children

作　　者：刘新光[1] 刘梦珂[2] 马统帅[1] Liu Xinguang;Liu Mengke;Ma Tongshuai(Department of Pediatrics,Shangqiu First People′s Hospital,Shangqiu 476100,China;Department of Oncology,Shangqiu First People′s Hospital,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院儿科,476100 [2]商丘市第一人民医院肿瘤科,476100

出　　处：《中华全科医师杂志》2021年第8期881-884,共4页Chinese Journal of General Practitioners

摘　　要：对2018年1月至2019年8月商丘市第一人民医院儿科收治的87例上消化道溃疡出血患儿(年龄2~8岁)资料进行回顾性分析,按治疗用药分为A组(奥美拉唑治疗,45例)、B组(乌司他丁^(+)奥美拉唑治疗,42例),奥美拉唑均为10 mg/d早餐前口服、共治疗2~4周,B组于早餐后输入乌司他丁(1~5)万IU/kg、1次/d,共1周。治疗后B组患儿有效率95.2%(40/42),高于A组的80.0%(36/45),差异具有统计学意义(χ^(2)=4.567,P=0.03);呕血停止时间、大便潜血转阴时间、住院时间显著低于A组,差异均有统计学意义(均P<0.05);流式细胞术检查显示,两组患儿治疗后CD3^(+)和CD4^(+)T细胞百分比显著升高,CD8^(+)T细胞百分比显著降低,且B组优于A组,差异均有统计学意义(均P<0.05)。两组治疗后血清降钙素原、超敏C反应蛋白和肿瘤坏死因子水平均显著降低,B组低于A组,差异均有统计学意义(均P<0.05)。不良反应为A组患儿出现恶心呕吐1例,腹痛腹泻1例,嗜睡1例;B组患儿恶心呕吐1例,腹痛腹泻1例。提示乌司他丁联合奥美拉唑治疗上消化道溃疡出血患儿效果较好,症状缓解时间较短,安全性较好。From January 2018 to August 2019,87 children aged 2 to 8 years with upper gastrointestinal ulcer bleeding were admitted to the Department of Pediatrics of Shangqiu First People′s Hospital.Patients were randomly assigned in two groups,45 cases received omeprazole for treatment(group A)and 42 cases received ulinastatin and omeprazole for treatment(group B).The omeprazole 10 mg/d was administrated orally for 2 to 4 weeks in two groups,while in group B additional ulinastatin injection (10000-50000) IU·kg^(-1)·d^(-1) was given for 1 week.The effective rate in group B was 95.2%(40/42),which was significantly higher than that in group A(80.0%,36/45)(χ^(2)=4.567,P=0.03).After treatment,gastroscopy showed that the time of hemostasis,the time of stopping hematemesis,the time of fecal occult blood turning negative,and the length of hospital stay in group B were significantly shorter than those in group A(P<0.05).The results of flow cytometry showed that the percentages of CD3^(+)and CD4^(+)increased and the percentages of CD8^(+)decreased significantly after treatment in the two groups,while the changes in group B were more marked than those in group A(P<0.05).Serum inflammatory factors(serum procalcitonin,high-sensitivity C-reactive protein and tumor necrosisα)were significantly reduced after treatment in the two groups,while the above indicators in group A were significantly lower than those in group A(all P<0.05).In group A,there was 1 case of nausea and vomiting,1 case of abdominal pain and diarrhea,and 1 case of lethargy;in group B,there was 1 case of nausea and vomiting and 1 case of abdominal pain and diarrhea.The study suggests that ulinastatin combined with omeprazole has a better effect than omeprasole alone in treatment of children with upper gastrointestinal ulcer bleeding without increasing adverse effects.

关 键 词：溃疡 胃肠道 儿童 乌司他丁 奥美拉唑 出血 

分 类 号：R725.7[医药卫生—儿科]