肠内应用抑酸药物治疗脑卒中患者40例

Intestinal application of acid suppression drugs in patients with cerebral apoplexy: An analysis of 40 cases

目的:探讨肠内应用抑酸药物治疗脑卒中患者的临床效果,为其研究提供参考依据.方法:2011-01/2013-12三亚市人民医院神经内科诊断为脑卒中的80例患者作为研究对象,采用随机数字法平均分为观察组与对照组两组,分别给予肠内抑酸药雷贝拉唑治疗和奥美拉唑静脉点滴治疗.对所有患者的胃黏膜pH值进行测定,同时清晨空腹抽血检测血清前列腺素E2(prostaglandin E2,PGE2)及表皮生长因子(epidermal growth factor,EGF)水平.结果:治疗后2、3 d观察组胃黏膜pH值明显上升,且高于对照组,差异均有统计学意义(7.35±0.09 vs 7.25±0.08,7.38±0.06 vs 7.34±0.08,P<0.05);治疗后4 d两组胃黏膜pH值恢复正常.治疗后两组患者血清PGE2及EGF水平均有明显升高,与治疗前相比差异有统计学意义(P<0.05);且观察组患者血清PGE2及EGF水平升高更明显,差异比较有统计学意义(0.41pg/mL±0.07 pg/mL vs 0.30 pg/mL±0.05 pg/mL,79.5 pg/mL±10.83 pg/mL vs 60.53 pg/mL±9.93 pg/mL,P<0.05).结论:肠内与静脉给予抑酸药治疗均可以有效预防脑卒中患者应激性溃疡的发生,但肠内给予可以更早抑制胃酸分泌,进而促进胃黏膜恢复正常.

AIM： To assess the clinical effects of intestinal application of acid suppression drugs in patients with cerebral apoplexy.METHODS： Eighty patients with cerebral apo- plexy were randomly divided into either an observation group or a control group. Patients in the observation group were given rabepra- zole by intestinal application, and patients in the control group were given omeprazole by in- travenous drip. The gastric mucosal pH, serum prostaglandin E2 （PGE2） and epidermal growth factor （EGF） levels were tested and compared between the two groups.RESULTS： Gastric mucosal pH values were increased 2 and 3 d after treatment, which were significantly higher in the observation group than in the control group （7.35 ± 0.09 vs 7.25 ±0.08, 7.38 ± 0.06 vs 7.34 ± 0.08, P 〈 0.05）. Gastric mucosal pH became normal 4 d after treatment. Serum PGE2 and EGF levels after treatment were significantly higher than those before treat- ment （P 〈 0.05）. Serum PGE2 and EGF levels af- ter treatment in the observation group were sig- nificantly higher than those in the control group （0.41 pg/mL ± 0.07 pg/mL vs 0.30 pg/mL ± 0.05 pg/mL, 79.5 pg/mL ± 10.83 pg/mL vs 60.53 pg/ mL ± 9.93 pe/mL, P 〈 0.05）.CONCLUSION： Intestinal and intravenous ap- plication of acid suppression drugs can effec- tively prevent the occurrence of stress ulcer in patients with cerebral apoplexy, but intestinal application can inhibit gastric acid secretion ear- lier to promote the recovery of the gastric mu- cosa.