缺血性中风病急性期患者在临床实践中常联合使用中成药和西药,该研究选择来源于14家三级甲等医院信息系统（hospital information system,HIS）中的27 678例缺血性中风病患者作为研究对象,以入院14 d内针对中风治疗的中西药物构建复杂网...缺血性中风病急性期患者在临床实践中常联合使用中成药和西药,该研究选择来源于14家三级甲等医院信息系统（hospital information system,HIS）中的27 678例缺血性中风病患者作为研究对象,以入院14 d内针对中风治疗的中西药物构建复杂网络,发现该网络具有无尺度现象,采用层次结构核心算法分别对急、危、一般3类入院病情患者入院1 d内,2~3,4~7,8~14 d 4个时间段的中西药物使用进行分析,发现3类入院病情患者核心中成药使用主要为活血化瘀和化痰醒脑药物,化痰醒脑药随时间变化在各类患者中使用逐渐减少。核心西药主要为抗血小板药、改善循环药物、神经保护药、抗凝药和脱水药,脱水药在入院病情为危的患者入院14 d内均为核心药物,而入院病情为一般的患者在入院3 d内作为核心药物使用,神经保护药的使用在患者入院7 d后逐渐下降。中西药物组合主要为神经保护药＋活血化瘀药、抗血小板药＋活血化瘀药、改善微循环药＋活血化瘀药;化痰醒脑药在入院病情急和一般的患者中主要与神经保护药联合使用,而入院病情为危的患者多与脱水药联合使用。该研究以大数据分析和复杂网络建模发现缺血性中风病患者急性期中西药物使用的动态特征和药物联合应用特点,为缺血性中风病急性期治疗策略的制定提供参考。展开更多
AIM： To observe the pharmacokinetics and pharmacodynamics of rabeprazole and compare serum gastrin concentrations in different CYP2C19 genotype groups. METHODS： The CYP2C19 genotype status of Chinese Han healthy vol...AIM： To observe the pharmacokinetics and pharmacodynamics of rabeprazole and compare serum gastrin concentrations in different CYP2C19 genotype groups. METHODS： The CYP2C19 genotype status of Chinese Han healthy volunteers was determined by polymerase chain reaction-restriction fragment length polymorphism method. Twenty H pylori-negative healthy subjects voluntary participated in the study. They were divided into the following three groups： homozygous extensive metabolizers （homEM）, heterozygous extensive metabolizers （hetEM） and poor metabolizers （PM）. After they orally received rabeprazole 20 mg once daily in the morning of d 1 and d 8, blood samples were collected at various time-points until 24 h after administration and intragastric pH values were monitored for 24 h by Digitrapper pH. Serum gastrin concentrations were measured by radioimmunoassay. Serum concentrations of rabeprazole were measured by high performance liquid chromatography. RESULTS： The mean AUC values for rabeprazole after a single and repeated doses were significantly different between the homEM and PM groups, but not between the homEM and hetEM, or the hetEM and PM groups. No significant differences in intragastric pH medians were observed among the three different genotype groups after a single dose or repeated doses. The ratio of pH medians between d 1 and d 8 ranged from 84% to 108%. The mean gastrin AUC values were also different among the three genotype groups, with a relative ratio of 1.0, 1.2 and 1.5 after a single dose and 1.0, 1.5 and 1.6 after repeated doses in the homEM, hetEM and PM groups, respectively. The gastrin AUC values among the three different genotype groups showed no significant difference either after a single dose or repeated doses. The subject who had lower intragastric acidity showed higher serum gastrin levels and concentrations of rabeprazole. CONCLUSION： In Chinese Han healthy people, the pharmacokinetics of rabeprazole are dependent on the CYP2C19 genotype status, but acid-inhibitory efficacy of rabeprazole and the gastrin level are not influenced significantly.展开更多
基金Natural Science Foundation of Anhui Education Department, No. 2003kj199
文摘AIM： To observe the pharmacokinetics and pharmacodynamics of rabeprazole and compare serum gastrin concentrations in different CYP2C19 genotype groups. METHODS： The CYP2C19 genotype status of Chinese Han healthy volunteers was determined by polymerase chain reaction-restriction fragment length polymorphism method. Twenty H pylori-negative healthy subjects voluntary participated in the study. They were divided into the following three groups： homozygous extensive metabolizers （homEM）, heterozygous extensive metabolizers （hetEM） and poor metabolizers （PM）. After they orally received rabeprazole 20 mg once daily in the morning of d 1 and d 8, blood samples were collected at various time-points until 24 h after administration and intragastric pH values were monitored for 24 h by Digitrapper pH. Serum gastrin concentrations were measured by radioimmunoassay. Serum concentrations of rabeprazole were measured by high performance liquid chromatography. RESULTS： The mean AUC values for rabeprazole after a single and repeated doses were significantly different between the homEM and PM groups, but not between the homEM and hetEM, or the hetEM and PM groups. No significant differences in intragastric pH medians were observed among the three different genotype groups after a single dose or repeated doses. The ratio of pH medians between d 1 and d 8 ranged from 84% to 108%. The mean gastrin AUC values were also different among the three genotype groups, with a relative ratio of 1.0, 1.2 and 1.5 after a single dose and 1.0, 1.5 and 1.6 after repeated doses in the homEM, hetEM and PM groups, respectively. The gastrin AUC values among the three different genotype groups showed no significant difference either after a single dose or repeated doses. The subject who had lower intragastric acidity showed higher serum gastrin levels and concentrations of rabeprazole. CONCLUSION： In Chinese Han healthy people, the pharmacokinetics of rabeprazole are dependent on the CYP2C19 genotype status, but acid-inhibitory efficacy of rabeprazole and the gastrin level are not influenced significantly.
