Yang Ming, Zhang Shu-Qin, Huang Jing
Department of Pharmacy, Pingshan County People's Hospital, Yibin, Sichuan, China.
Department of Pharmacy, Wuhan Pu Ren Hospital, Wuhan, Hubei, China.
Front Pharmacol. 2025 Jun 18;16:1623530. doi: 10.3389/fphar.2025.1623530. eCollection 2025.
BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a serious complication of peptic ulcer (PU), particularly in elderly patients who are at higher risk for adverse outcomes. While pantoprazole is widely used for acid suppression, adding octreotide may enhance hemostatic efficacy by reducing splanchnic blood flow. This study evaluates the efficacy of octreotide combined with pantoprazole in managing UGIB in elderly PU patients. METHODS: A retrospective evaluation was conducted from January 2021 to December 2023, including 116 elderly patients (≥60 years) diagnosed with PU and UGIB. Patients were divided into two groups: the control group (n = 60), receiving pantoprazole, and the observation group (n = 56), receiving a combination of octreotide and pantoprazole. Both groups received standard supportive care. Key clinical indicators assessed included hemostasis time, gastric pH, hemoglobin levels, and coagulation parameters, such as prothrombin time (PT), thrombin time (TT), and fibrinogen (Fib) levels. Statistical analysis was performed using SPSS software (Version 27.0), with a significance threshold of p < 0.05. RESULTS: The observation group exhibited a significantly higher effective hemostasis rate (91.07%) compared to the control group (73.33%, p = 0.013). Hemostasis time was shorter in the observation group (27.35 ± 3.52 h) than in the control group (33.04 ± 4.45 h, p < 0.001). Post-treatment gastric pH was significantly higher in the observation group (6.74 ± 1.38) compared to the control group (5.29 ± 1.20, p < 0.001), contributing to improved ulcer healing. Hemoglobin levels and coagulation function (PT, TT, and Fib levels) also showed greater improvement in the observation group, suggesting enhanced recovery and hemostatic stability. CONCLUSION: The combination of octreotide and pantoprazole is associated with improved hemostatic efficacy in elderly patients with peptic ulcers and upper gastrointestinal bleeding. It is linked to reduced hemostasis time, optimized gastric pH, and improved coagulation function. These findings suggest its potential as a promising approach for managing UGIB in this population.
背景：上消化道出血（UGIB）是消化性溃疡（PU）的一种严重并发症，尤其是在老年患者中，他们发生不良后果的风险更高。虽然泮托拉唑广泛用于抑制胃酸分泌，但加用奥曲肽可能通过减少内脏血流量来提高止血效果。本研究评估奥曲肽联合泮托拉唑治疗老年PU患者UGIB的疗效。 方法：对2021年1月至2023年12月期间116例诊断为PU和UGIB的老年患者（≥60岁）进行回顾性评估。患者分为两组：对照组（n = 60）接受泮托拉唑治疗，观察组（n = 56）接受奥曲肽和泮托拉唑联合治疗。两组均接受标准的支持治疗。评估的关键临床指标包括止血时间、胃pH值、血红蛋白水平和凝血参数，如凝血酶原时间（PT）、凝血酶时间（TT）和纤维蛋白原（Fib）水平。使用SPSS软件（版本27.0）进行统计分析，显著性阈值为p < 0.05。 结果：观察组的有效止血率（91.07%）显著高于对照组（73.33%，p = 0.013）。观察组的止血时间（27.35 ± 3.52小时）短于对照组（33.04 ± 4.45小时，p < 0.001）。治疗后观察组的胃pH值（6.74 ± 1.38）显著高于对照组（5.29 ± 1.20，p < 0.001），有助于溃疡愈合改善。观察组的血红蛋白水平和凝血功能（PT、TT和Fib水平）也有更大改善，表明恢复和止血稳定性增强。 结论：奥曲肽和泮托拉唑联合使用可提高老年消化性溃疡合并上消化道出血患者的止血疗效。它与缩短止血时间、优化胃pH值和改善凝血功能有关。这些发现表明其作为该人群管理UGIB的一种有前景的方法的潜力。
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