奥美拉唑联合血凝酶对老年胃溃疡伴出血的临床疗效及作用机制探讨

Discussion on the Clinical Efficacy and Mechanism of Omeprazole Combined with Hemocoagulase for the Treatment of Elderly Gastric Ulcer Complicated with Bleeding

目的探讨奥美拉唑联合血凝酶治疗老年胃溃疡合并出血的临床疗效以及作用机制。方法选择我院收治的80例老年胃溃疡合并出血患者,随机分为两组各40例。在常规治疗的基础上,对照组采用奥美拉唑治疗,观察组采用奥美拉唑联合血凝酶治疗,比较两组患者的止血效果、溃疡愈合情况,以及治疗前后的细胞因子水平。结果观察组在治疗后24 h、48 h、72 h的止血率均显著高于对照组,差异有统计学意义(P<0.05)。观察组的溃疡愈合总有效率为95.0%,显著高于对照组的75.0%,差异有统计学意义(P<0.05)。两组患者治疗后TNF-α均显著下降,SOD、VEGF及EGF均显著升高(P<0.05),且观察组各项指标均显著优于对照组(P<0.05)。结论采用奥美拉唑联合血凝酶治疗老年胃溃疡合并出血患者具有显著的临床效果,可提高止血率,促进溃疡的愈合,其作用机制可能与抑制TNF-α水平,提高SOD、VEGF及EGF水平有关。

Objective To investigate the clinical efficacy and mechanism of omeprazole combined with hemocoagulase for the treatment of elderly gastric ulcer complicated with bleeding. Methods 80 cases of elderly patients with gastric ulcer complicated with bleeding were selected and randomly divided into two groups equally. On the basis ofregnlar treatmeng, the control group received omeprazole, while the observation group was treated with omeprazole combined with hemocoagulase. The hemostasis effect, healing condition of ulcer, and the cytokine levels before and after treatment were compared between two groups. Results The bemostasis rates at 24 h, 48 h and 72 h after treatment of observation group were significantly higher than those of control group （P 〈0.05）. The total effective rate of ulcer healing of observation group was 95.0%, significantly higher than 75.0% of control group （P 〈0.05）. After treatment, both groups had significantly decreased TNF-α level, and significantly increased SOD, VEGF and EGF levels （P〈0.05）; The observation group was superior to the control group in the levels of TNF-α, SOD, VEGF and EGF after treatment （P〈0.05）. Conclusions Omeprazole combined with hemocoagulase for the treatment of elderly gastric ulcer complicated with bleeding has significant clinical effect, which can improve the hemostasis rate and promote the healing of ulcer. The mechanism may be related to the inhibition of TNF-t~ level, and increase of SOD, VEGF and EGF levels.