埃索美拉唑与奥美拉唑治疗消化性溃疡出血的疗效比较

Comparison between esomeprazole and omeprazole in treatment of peptic ulcer bleeding

目的比较埃索美拉唑与奥美拉唑治疗消化性溃疡出血(PUB)的临床疗效。方法前瞻性纳入2020年1月至2021年12月收治的PUB患者160例,随机分为对照组(n=80)和观察组(n=80)。对照组给予奥美拉唑治疗,观察组给予埃索美拉唑治疗。治疗过程中测定并对比分析2组患者胃内酸性水平及患者CYP2C19等位基因(*2,*3,*17),比较2组患者的临床疗效、住院时间、30 d内的再出血率和不良反应事件发生率。结果观察组总有效率显著高于对照组(96.25%vs 78.75%,P<0.01);快代谢型患者中,观察组总有效率显著高于对照组(93.10%vs 56.25%,P<0.01)。2组患者24 h内胃内平均p H差异无统计学意义,但胃内p H达4.0、6.0的时间,及p H>4.0和>6.0的持续时间百分率之间差异均存在统计学意义(P<0.05)。观察组住院时间显著短于对照组(P<0.05),但2组患者30 d内再出血率、不良反应发生率比较差异无统计学意义。结论采用埃索美拉唑治疗PUB的临床疗效优于奥美拉唑。

AIM To compare the clinical efficacy between esomeprazole and omeprazole in the treatment of peptic ulcer bleeding(PUB).METHODS A total of 160 patients with PUB admitted to our hospital from January 2020to December 2021 were enrolled prospectively and randomly divided into 2 groups,with 80 patients in each group.The control group was given omeprazole treatment,and the observation group was given esomeprazole treatment.During treatment,gastric acid level and CYP2C19 allele(*2,*3,*17)of patients in 2 groups were measured and compared.The differences of effective rate,hospitalization time,rebleeding rate within 30 d and occurrence of adverse reactions were compared between 2 groups.RESULTS The total effective rate of the observation group was significantly higher than that of the control group(96.25%vs 78.75%,P<0.01).In extensive metabolizer(EM)type patients,the total effective rate in observation group was significantly higher than that in control group(93.10%vs 56.25%,P<0.01).There was no statistical difference in average gastric pH within 24 h between 2 groups,but there were significant differences between the time when the intra gastric pH reached to 4.0 and 6.0,and the percentage of the duration of pH>4.0 and>6.0(P<0.05).The hospitalization time of the observation group was significantly shorter than that of the control group(P<0.05),but there were no significant differences in the rate of rebleeding within 30 d and the occurrence of adverse reactions.CONCLUSION The clinical efficacy of esomeprazole in the treatment of PUB is better than that of omeprazole.