静脉应用抑酸药物胃内24小时pH监测

Inhibitory Effect on Gastric Acid in 24 Hours by H_2 Receptor Antagonists (H_2A) and Proton Pump Inhibitors(PPI)

为了探讨组胺 H2 受体拮抗剂和质子泵抑制剂静脉给药对胃酸的抑制作用。 2 0例十二指肠球部溃疡患者 ,随机分为 5组。每组 4例 ,进行胃内 2 4小时 pH监测。结果显示 :用药后各组 pH >4,pH >6的时间 ,洛赛克 1、2组与奥美拉唑组分别为 999.0± 416 .4、6 6 1.8± 45 6 .6分钟 ,132 0 .0± 6 6 .1、114 0 .0± 2 2 2 .0分钟和 10 5 0 .0± 30 0 .0、870 .0±336 .0分钟 ,法莫替丁组为 336 .6± 14 4 .0、79.8± 32 .4分钟 ,雷尼替丁组为 2 0 4.0± 18.0、10 0 .2± 2 2 .8分钟。质子泵抑制剂组明显长于H2 受体拮抗剂组。H2 受体拮抗剂常规剂量一次用药 ,胃内 pH控制不理想。提示 :当十二指肠溃疡合并出血时 ,宜使用质子泵抑制剂。

Twenty cases of patients with duodenal ulcer were allotted randomiy into 5 groups to evaluate the inhibitory effect on gastric acid by H_2 receptor antagonists (H_2A) and proton pump inhibitors( PPI). Intragastric pH monitor was performed in each patient for 24 hours. Results: Duration of pH>4 and pH>6 after administer were 999.0±416.4 and 661.8±456.6, 1320.0±66.1 and 1140.0±222.0, 1050.0±300.0 and 870.0±336.0, 336.6±144.0 and 79.8±32.4, 204.0±18.0 and 100.2±22.8 minutes in losec 1 group, losec 2 group, omeprazde group, famotidine group and ranitidine group, respectively. Duration of acid inhibition was significantly longer in PPI groups than H_2A groups. Ideal inhibition of intragastric pH cannot be achieved by single dose of H_2A of conventional dosage. It is suggested that PPIs are appropriately indicated when bleeding is complicated with peptic ulcer.