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目的探究上消化道出血患者使用泮托拉唑治疗的药效学和药动学的变化特点。方法入选消化科住院的上消化道出血患者共243例。其中糜烂性胃炎患者共30例,十二指肠溃疡患者160例,胃溃疡患者53例。泮托拉唑组164例,奥美拉唑组79例。根据泮托拉唑剂量的不同分为40mg组和80mg组,奥美拉唑为80mg组,均用药14d。观察患者一般临床表现、出血情况,测定用药后24h内胃内平均pH值。评估药效学结果。检测奥美拉唑与泮托拉唑80mg组治疗前后血清高敏C反应蛋白、外周血白细胞水平及白细胞介素-8的浓度,对所得结果用统计软件行统计分析。结果 1三组间24h胃内pH值水平间差异无统计学意义(均P<0.05)。2在对炎症因子的影响上,泮托拉唑80mg和奥美拉唑80mg组,二组治疗后对高敏C反应蛋白、外周血白细胞水平及白细胞介素-8间的影响,差异有统计学意义(均P<0.05)。3在药效学分析过程中发现,泮托拉唑40mg和80mg组的显效性显著高于奥美拉唑80mg组,差异有统计学意义(P<0.05),有效性和无效性间的差异无统计学意义(均P>0.05)。结论泮托拉唑在治疗上消化道出血上的显效性要高于奥美拉唑。
Objective To investigate the changes of pharmacodynamics and pharmacokinetics of pantoprazole in patients with upper gastrointestinal bleeding. Methods A total of 243 cases of upper gastrointestinal bleeding admitted to the Department of Gastroenterology. Erosive gastritis in patients with a total of 30 cases, 160 cases of duodenal ulcer patients, 53 cases of gastric ulcer patients. 164 in the pantoprazole group and 79 in the omeprazole group. According to the dose of pantoprazole is divided into 40mg group and 80mg group, omeprazole 80mg group, were medication 14d. Observe the general clinical manifestations, bleeding, determination of intragastric pH within 24h after treatment. Evaluate pharmacodynamic results. Serum high-sensitivity C-reactive protein, peripheral blood leukocytes and interleukin-8 levels were measured before and after treatment with omeprazole and pantoprazole 80mg, and the results were statistically analyzed by statistical software. Results There was no significant difference in 24h gastric pH value between the three groups (all P <0.05). 2 on the impact of inflammatory cytokines, pantoprazole 80mg and omeprazole 80mg group, the two groups after treatment on the high-sensitivity C-reactive protein, peripheral blood leukocytes and interleukin -8 between the differences were statistically significant Significance (all P <0.05). 3 In the course of pharmacodynamics analysis, the potent pantoprazole 40mg and 80mg group was significantly higher than the omeprazole 80mg group, the difference was statistically significant (P <0.05), the difference between effectiveness and ineffectiveness No statistical significance (all P> 0.05). Conclusions Pantoprazole is superior to omeprazole in the treatment of upper gastrointestinal bleeding.