关键词: H2 受体拮抗剂;质子泵抑制剂;消化性溃疡

    中图号:R573.1

    摘 要:目的 比较抑酸药H2 受体拮抗剂(H2 A)与质子泵抑制剂(PPI)对消化性溃疡出血的疗效. 方法 ①30只SD大鼠随机分成6组，制备急性胃溃疡出血模型，以不同pH值的缓冲液冲洗胃溃疡部位后记录其胃粘膜出血时间(GMBT).②24例消化性溃疡急性出血患者，随机分2组，24h内洛赛克组静滴40mg洛赛克，法莫替丁组静滴40mg法莫替丁，动态测定给药前1h及给药后24h胃内pH值.③回顾性分析272例应用洛赛克(40mg静滴，1次 d-1 )与270例应用法莫替丁(40mg静滴，2次 d-1 )的消化性溃疡出血患者手术率与死亡率. 结果 当pH≥6.0时大鼠GMBT明显缩短(P<0.05).胃内pH值监测结果，用药后各组pH>4.0，pH>6.0的时间，洛赛克组比法莫替丁组显著延长(P<0.01).洛赛克治疗组手术率比法莫替丁治疗组明显减低(P<0.05)，而死亡率无显著差异. 结论 对急性消化性溃疡出血，质子泵抑制剂的抑酸止血效果明显高于H2 受体拮抗剂.

    PPI vs H2 A which is stronger inhibitor on acute peptic ulcer bleeding?

    CAO Yi-Zhan，LIU Li，WANG Bo-Liang，LU Jiang，HE Bao-Jian，ZHONG Yue-Xia

    ，SONG De-Gen ，JIANG Hua

    1 Department of Emergency Medicine，2 Department of Gastroenterology，Tangdu Hospital，Fourth Mil-itary Medical University，Xi'an710038，China，3 Department of Gastroenterology，General Hospital of Chinese PLA，Beijing100853，China

    Keywords:H2 -receptor antagonist;proton-pump inhibitor;peptic ulcer

    Abstract:AIM To investigate therapeutic effects of H2 -re-ceptor antagonists(H2 A)and proton-pump inhibitors(PPI)on peptic uleer bleeding.METHODS Thirty SD rats were randomly divided into6groups after gastric mucosal ulcer models were reproduced.The gastric mucosal bleeding time(GMBT)of the5groups was measured after the perfusion of ulcer site with pH3.0 ......