尖吻蝮蛇血凝酶联合泮托拉唑治疗急性上消化道出血的疗效  

Efficacy of hemocoagulase agkistrodon combined with pantoprazole in the treatment of acute upper gastrointestinal bleeding

作　　者：高文 王辉[1] 石永强 陈跃 高攀 Gao Wen;Wang Hui;Shi Yongqiang(Department of Gastroenterology,Nanjing Lishui People's Hospital,Zhongda Hospital Lishui Branch,Southeast University,Nanjing 211200,China)

机构地区：[1]东南大学附属中大医院溧水分院消化内科,南京211200

出　　处：《中华保健医学杂志》2024年第6期739-742,共4页Chinese Journal of Health Care and Medicine

基　　金：2022年度南京市卫生科技发展专项资金项目计划(YKK22240)。

摘　　要：目的探讨尖吻蝮蛇血凝酶(HUG)联合泮托拉唑治疗急性上消化道出血(AUGB)的效果。方法选取2022年1月~2023年12月东南大学附属中大医院溧水分院收治的110例AUGB患者。采用随机数表法将患者随机分为对照组与观察组,每组55例,分别予以泮托拉唑、HUG联合泮托拉唑治疗,均治疗5 d。比较两组患者入院后止血时间、出血量和治疗5 d后的疗效,血液流变学指标[全血黏度、红细胞比容(PCV)],炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]和氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)],并观察不良反应发生情况。结果治疗后,观察组患者的总有效率为96.36%(53∕55),高于对照组患者的85.45%(47∕55),差异有统计学意义(χ^(2)=3.960,P<0.05)。治疗后,观察组患者的全血高切黏度分、血细胞比容(HCT)分别为(4.36±0.67)mPa∕s、(42.76±5.17)%,均高于对照组患者的(3.98±0.61)mPa∕s、(39.45±5.37)%,差异均有统计学意义(t=3.110、3.293,P<0.05)。治疗后,观察组患者的血清CRP、IL-6水平分别为(7.17±2.21)mg∕L、(28.45±7.25)ng∕L,均低于对照组患者的(9.25±2.76)mg∕L、(34.65±8.41)ng∕L,差异均有统计学意义(t=4.363、4.141,P<0.05)。治疗后,观察组患者的血清SOD水平为(78.36±13.87)U∕ml,高于对照组患者的(71.69±11.45)U∕ml;MDA水平为(5.47±1.24)U∕ml,低于对照组患者的(6.39±1.31)U∕ml,差异均有统计学意义(t=2.750、3.783,P<0.05)。两组患者的不良反应发生率比较(9.09%vs.5.45%),差异无统计学意义(χ^(2)=0.135,P>0.05)。结论HUG联合泮托拉唑治疗AUGB的疗效较好,对患者的血液流变学、炎症和氧化应激均具有较好的改善作用,可缩短止血时间,安全性高。Objective To investigate the effect of hemocoagulase agkistrodon(HUG)combined with pantoprazole in the treatment of acute upper gastrointestinal bleeding(AUGB).Methods 110 patients with AUGB were randomly divided into control group and observation group,55 cases in each group.They were treated with pantoprazole,HUG combined with pantoprazole,respectively.Both groups were treated for 5 days.The hemostatic time,bleeding volume and curative effect after 5 days of treatment were compared between the two groups.The hemorheology[whole blood viscosity,hematocrit(HCT)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)]and oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD)]were compared between the two groups,and adverse reactions were observed.Results Compared with the control group(85.45%),the total effective rate of the observation group(96.36%)was higher,and the difference was significant(χ^(2)=3.960,P<0.05).After treatment,compared with the control group,the whole blood viscosity,HCT and SOD in the observation group increased[(4.36±0.67)mPa∕s vs.(3.98±0.61)mPa∕s,(42.76±5.17)%vs.(39.45±5.37)%,(78.36±13.87)U∕ml vs.(71.69±11.45)U∕ml](t=3.110,3.293,2.750,P<0.05),serum CRP,IL-6 and MDA levels decreased[(7.17±2.21)mg∕L vs.(9.25±2.76)mg∕L,(28.45±7.25)ng∕L vs.(34.65±8.41)ng∕L,(5.47±1.24)U∕mL vs.(6.39±1.31)U∕mL](P<0.05)(t=4.363,4.141,3.783,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(9.09%vs.5.45%,χ^(2)=0.135,P>0.05).Conclusion HUG combined with pantoprazole is effective in the treatment of AUGB,which can improve the hemorheology,inflammation and oxidative stress of patients,it can shorten the hemostasis time,and has good safety.

关 键 词：急性上消化道出血 尖吻蝮蛇血凝酶 泮托拉唑 血液流变学 

分 类 号：R573.2[医药卫生—消化系统]