消化性溃疡出血患者使用生长抑素抑制胃酸分泌效果优于潘托拉唑:一项前瞻性、随机、安慰剂对照试验

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:sunday_sky
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Objective. Gastric acid inhibition is beneficial in the management of peptic ulcer bleeding (PUB). The aim of this double-blind study was to test whether somatostatin (SST) increases intragastric pH in PUB as compared with pantoprazole (PAN) and placebo (PLA). Material and methods. Eligible patients were randomized to receive SST (500 μg/h +250 μg bolus), or PAN (8 mg/h+80 mg bolus) or PLA (normal saline) i.v., for 24 h. All patients underwent gastric pH monitoring during the infusion of the trial drugs. Results. The three groups (SST, n = 14; PAN, n = 14; PLA, n = 15) were comparable for age, gender, aetiology of PUB and laboratory data at admission. Mean (±SE) baseline pH levels in the fundus increased during the administration of the trial drugs (SST: 1.94±0.18 to 6.13±0.37, p < 0.000 1; PAN: 1.93±0.16 to 5.65±0.37, p < 0.000 1;PLA: 1.86±0.12 to 2.10±0.15, p = 0.091 7). During the first 12 h of infusion, the mean (±SE) percentage time spent above pH 4.0 and 5.4 was higher with SST versus PAN (84.4%±4.8 versus 55.1%±8.3, p = 0.004 9 and 74.2%±6.5 versus 47.1%±8.3, p = 0.016 3, respectively) and there was a trend favouring the SST group regarding the time spent above pH 6.0 and 6.8 (65.7%±6.4 versus 43.3%±8.2, p = 0.066 9 and 49.2%±7.7 versus 28.4±6.6, p = 0.073 8, respectively). Conclusions. In PUB, both SST and PAN inhibit gastric acid secretion as compared with placebo. However, during the first 12 h of the infusion, SST was more effective than PAN in maintaining high intragastric pH. These results may provide a rationale for the administration of SST in PUB. Objectives. This aim of this management-of-peptic ulcer bleeding (PUB). The aim of this double-blind study was to to test whether somatostatin (SST) increases intragastric pH in PUB as compared with pantoprazole (PAN) and placebo ). Material and methods. Eligible patients were randomized to receive SST (500 μg / h + 250 μg bolus), or PAN (8 mg / h + 80 mg bolus) or PLA (normal saline) iv for 24 h. All patients The three groups (SST, n = 14; PAN, n = 14; PLA, n = 15) were compared for age, gender, aetiology of PUB and laboratory data at Mean (± SE) baseline pH levels in the fundus increased during the administration of the trial drugs (SST: 1.94 ± 0.18 to 6.13 ± 0.37, p <0.000 1; PAN: 1.93 ± 0.16 to 5.65 ± 0.37, p <0.000 1; PLA: 1.86 ± 0.12 to 2.10 ± 0.15, p = 0.091 7) During the first 12 h of infusion, the mean (± SE) percentage of the time spent above pH 4.0 and 5.4 was higher with SST versus PAN (84.4% ± 4.8 versus 55.1% ± 8.3, p = 0.004 9 and 74.2% ± 6.5 versus 47.1% ± 8.3, p = 0.016 3, respectively) and there was a trend favored the SST group regarding the time spent above pH 6.0 and 6.8 (65.7% ± 6.4 versus 43.3% ± 8.2, p = 0.066 9 and 49.2% ± 7.7 versus 28.4 ± 6.6, p = 0.073 8, respectively). Conclusions. In PUB, both SST and PAN inhibit gastric acid However, during the first 12 h of the infusion, SST was more effective than PAN in maintaining high intragastric pH. These results may provide a rationale for the administration of SST in PUB.
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