Yang Hui-Xiang, Luo Dan, Zou Yi-You
Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2007 Apr;32(2):295-8.
To observe the effect of ranitidine on gastric acid, plasma endothelin, and calcitonin gene-related peptide (CGRP) in patients undergoing the brain operation, and to explore the possible pathogenesis of ranitidine on preventing from gastric mucosal injury under the stress.
Thirty patients who underwent brain surgery were randomly divided into 2 groups: Fifteen patients in the control group did not use ranitidine and the other 15 in the treatment group received ranitidine 150 mg intravenously twice daily besides the routine therapy. We continuously monitored the gastric pH value from 4 hours pre-operatively to 72 hours post-operatively in the 30 patients. We also determined the plasma endothelin and CGRP levels of the patients at the 4th hour pre-operatively and at the 4th, 24th, and 72nd hours post-operatively.
In the control group there was no significant difference between the mean intra-gastric pH values pre-operatively and post-operatively (P> 0.05). In the treatment group the level of intra-gastric pH was much higher than that in the control group (P< 0.05). In the control group, the level of plasma endothelin significantly higher and the level of calcitonin gene-related peptide significantly lower than that pre-operatively (P< 0.01), but the level of plasma endothelin significantly was lower and the level of calcitonin gene-related peptide obviously higher in the post-operative treatment group than that pre-operatively (P< 0.01).
The brain operation obviously influences the endogenous plasma endothelin and CGRP levels, but its influence on the intra-gastric acid is not visible. Ranitidine can obviously decrease the level of intra-gastric acid, and improve the macrocirculation of gastric mucous membrane by decreasing ET and increasing the CGRP level.
观察雷尼替丁对脑外科手术患者胃酸、血浆内皮素及降钙素基因相关肽（CGRP）的影响，探讨雷尼替丁在应激状态下预防胃黏膜损伤的可能发病机制。
将30例脑外科手术患者随机分为2组：对照组15例未使用雷尼替丁，治疗组15例在常规治疗基础上每日静脉滴注雷尼替丁150mg，2次/d。连续监测30例患者术前4小时至术后72小时的胃内pH值。同时测定患者术前4小时及术后4小时、24小时、72小时的血浆内皮素和CGRP水平。
对照组术前、术后胃内平均pH值差异无统计学意义（P>0.05）。治疗组胃内pH值水平明显高于对照组（P<0.05）。对照组术后血浆内皮素水平明显高于术前，降钙素基因相关肽水平明显低于术前（P<0.01），而治疗组术后血浆内皮素水平明显低于术前，降钙素基因相关肽水平明显高于术前（P<0.01）。
脑外科手术明显影响内源性血浆内皮素和CGRP水平，但对胃内酸度的影响不明显。雷尼替丁可明显降低胃内酸度，通过降低内皮素水平、升高CGRP水平改善胃黏膜微循环。
