奥美拉唑联合谷氨酰胺治疗新生儿消化道出血的效果及对氧化应激指标的影响

The Effect of Glutamine Combined with Omeprazole in Neonate with Upper Gastrointestinal Tract Bleeding and Its Clinical Significance on Oxidative Stress

目的:观察奥美拉唑联合谷氨酰胺治疗新生儿上消化道出血的效果及对患儿氧化应激状态的影响。方法:选取2014年1月至2016年6月我院收治的上消化道出血新生儿104例,采用随机数表法分为对照组和观察组各52例。对照组给予奥美拉唑0.8 mg/kg静脉滴注,2次/天;观察组在对照组基础上加用谷氨酰胺1.5 mg/kg静脉滴注,1次/天。两组患儿均治疗3 d。治疗前后采用分光光度分析法检测患儿血清超氧化物歧化酶(SOD)、比色法检测丙二醛(MDA)水平,观察临床疗效和不良反应发生情况。结果:治疗前,两组患儿SOD、MDA比较差异无统计学意义(P>0.05);治疗后,观察组患儿SOD的升高幅度、MDA的降低幅度均大于对照组,差异有统计学意义(P<0.05)。观察组出血停止时间、隐血转阴时间均短于对照组(P<0.05);观察组总有效率92.3%,高于对照组的80.8%,但差异无统计学意义(P>0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:奥美拉唑联合谷氨酰胺治疗新生儿上消化道出血,可有效抑制患儿的氧化应激反应,临床疗效显著,使用安全。

Objective： To observe the effect of glutamine combined with omeprazole in neonate with upper gastrointestinal tract bleeding and its clinical significance on oxidative stress. Methods： A total of 104 neonates with upper gastrointestinal tract bleeding were randomly divided into control group （ n = 52） and observation group （ n = 52）. The control group was given omeprazole （ 0.8 mg/kg, 2 times/day） , and the observation group was treated with omeprazole ＋ glutamine （ 1.5 mg/kg, 1 times/day）, continuous administration of 3 days. Superoxlde dismutase （SOD） was detected by spectrophotometry, and the malondialdehyde （MDA） was detected by colorimetrie method. The clinical effect and adverse reaction were compared. Results： There were no significant differences of SOD and MDA between the two groups before treatment （P〉0.05）. After treatment, SOD was higher in observation group than that in control group （P〈0.05） and MDA was lower in observation group than that in control group （ P〈0.05 ）. The stop time of bleeding and occult blood test negative time in observation group were shorter than control group （P〈0.05）. The clinical effect rate in observation was 92.3% , which was higher than that of 80.8% in control group （ P〉0.05 ）. The rate of adverse reactions was no significant difference between the two groups （P〉0. 05 ）. Conclusion： Glutamine combined with omeprazole can inhibit oxidative stress in neonate with upper gastrointestinal tract bleeding, with significantly clinical effect and safety.