监测胃24小时pH动态观察泰胃美治疗十二指肠球溃疡抑酸效果

Continuous Monitoring of Gastric pH for Observing Antisecretory Effects of Tagamet on Duodenal Ulcer Patients

对25例十二指肠球溃疡(Du)患者投予泰胃美(Tagamet,TA),并以硫糖铝作对照,使用单晶体锑电极连接Digitrapper MK Ⅲ型pH记录仪,监测服药前后胃内24小时pH变化.观察TA对胃酸分泌的影响。分别在24小时,8Am～8Pm和8Pm～8Am的三个时间段进行分析,以24小时胃内pH>3的总时间和时间百分率、平均pH、中位pH和pH密度分布为判定指标。结果显示:TA组服药后24小时和夜间8Pm～8Am段pH明显升高(均P<0.01);在8Am～8Pm段升高不显著(均P>0.05);TA组与硫糖铝组比较,前者的各项pH指标除中位pH外均比后者显著升高(P<0.05或P<0.001)。Du患者服药前和服硫糖铝后pH密度分布呈左倾单峰形态,服TA后呈双峰形态。提示:每晚服TA 0.8g后,能适中地抑制夜间胃酸分泌,白天则无明显胃酸抑制作用。硫糖铝无抑酸作用。

Twenty-five patients with duodenal ulcer were randomly divided into two groups,treated with Tagamet and sucralfate respectively. Monocrystant electrode was used to monitor the fluctuation of 24-hour intragastric pH before and after medication for observing the influence of Tagamet on the secretion of gastric acid. The results were analyzed in three different time intervals (24-hour, 8am-8pm, 8pm-8am)and showed that pH parameters increased significantly after taking Tagamet (P<0. 001), and in the night time were higher than that in the daytime, while no changes were noted after taking sucralfate(.P>3. 05). The mean pH and total time pH>3 in the Tagamet group were higher than that in the sucralfate group (P<0. 05). Leftskewed ,unimodal density distribution of pH were found in all subjects before medication and remaind the same after taking sucralfate, whereas bi-modal density distribution of pH occurred in the subjects taking Tagamet. The data above suggest that antisecre-tion in the night time was stronger than that in the daytime after taking Tagamet. Conversely,sucralfate had no antisecretory action.