法莫替丁治疗儿童上消化道出血理想剂量探讨

Study of Ideal Therapeutic Dose of Famotidine for Children with Upper Gastrointestinal Hemorrhage

目的:探讨法莫替丁治疗儿童上消化道出血的理想治疗剂量。方法:将180例儿童上消化道出血患儿随机分为A组、B组、C组各60例。A组与B组患儿均给予法莫替丁治疗,A组患儿给予法莫替丁每次0.9 mg/kg,B组患儿给予法莫替丁每次0.5 mg/kg,C组患儿给予奥美拉唑每次0.9 mg/kg,每天2次给药,三组用药疗程均为7 d。结果:(1)三组疗效比较差异有统计学意义(P<0.05),B组治疗效果显著差于A组与C组(P<0.05),A组与C组治疗效果比较差异无统计学意义(P>0.05)。(2)A组患儿药物起效时间显著短于B组,疗效维持时间显著长于B组,差异有统计学意义(P<0.05)。(3)用药后30 min、1 h、2 h,A组患儿血药浓度显著高于B组(P<0.05);用药后4 h、8 h、12 h,A组与B组患儿血药浓度比较差异无统计学意义(P>0.05)。三组患儿白细胞下降、肾功能损伤等不良反应发生率比较差异无统计学意义(P>0.05)。结论:法莫替丁0.9 mg/kg、每天2次给药治疗儿童上消化道出血可以获得理想的疗效与安全性。

Objective： To explore the ideal therapeutic dose of famotidine for children with upper gastrointestinal hemorrhage.Methods： One hundred and eighty children with upper gastrointestinal hemorrhage were randomly divided into group A（ 60 cases）,group B（ 60 cases） and group C（ 60 cases）. Children in group A and group B were treated with famotidine for seven days,and the doses were 0. 9 mg / kg and 0. 5 mg / kg,two times every day respectively; while group C was given omeprazole for seven days,and the dose was 0. 9 mg / kg,two times every day. Results：（ 1） The therapeutic efficacy in three groups showed significant difference（ P〈0. 05）,and the therapeutic efficacy in group B was obviously lower than those in group A and group C（ P〈0. 05）,while no obvious difference was found between group A and group C（ P〉0. 05）.（ 2） The onset time in group A was obviously shorter than that in group B（ P〈0. 05）,while the duration of curative effect was obviously longer than that in group B（ P〈0. 05）.（ 3） 30 min,1 h and 2 h after administration,the concentration of blood famotidine in group A was obviously higher than those in group B respectively（ P 〈 0. 05）.4 h,8 h and 12 h after administration,no obvious difference was found between group A and group B（ P〉0. 05）.（ 4） There were no obvious difference in the incidence of leucopenia and renal dysfunction among the three groups（ P 〉 0. 05）. Conclusion： Famotidine with the dose of 0. 9 mg / kg,two times every day for children with upper gastrointestinal hemorrhage shows good efficacy and safety.