Weigelt J A, Aurbakken C M, Gewertz B L, Snyder W H
Arch Surg. 1981 May;116(5):597-601. doi: 10.1001/archsurg.1981.01380170077013.
Seven-seven critically ill patients were prospectively randomized into four groups to compare antacids and various doses of cimetidine in the neutralization of gastric acid for preventing complications of stress ulcers. Gastric pH was monitored hourly, basing the efficacy of neutralization on preselected pH values for each study group. Cimetidine provided adequate neutralization in 14 (23%) of 61 patients. Gastric acid in all 16 patients treated with antacids was adequately neutralized. Stress bleeding occurred in three (5%) patients treated with cimetidine and in no patient treated with antacids. Reversible thrombocytopenia developed in six (26%) of 23 patients treated with 2,400 mg/day of cimetidine. Hourly monitoring of gastric pH is a mandatory component in the prevention of stress bleeding. Antacid is the preferred agent for gastric acid neutralization because it is more effective, safer, and less expensive.
77例重症患者被前瞻性随机分为四组，以比较抗酸剂和不同剂量西咪替丁在中和胃酸以预防应激性溃疡并发症方面的效果。每小时监测胃内pH值，根据每个研究组预先设定的pH值来判断中和效果。61例使用西咪替丁的患者中，有14例（23%）实现了充分中和。所有16例使用抗酸剂治疗的患者胃酸均得到充分中和。使用西咪替丁治疗的患者中有3例（5%）发生应激性出血，而使用抗酸剂治疗的患者中无一例发生。接受每日2400毫克西咪替丁治疗的23例患者中有6例（26%）出现可逆性血小板减少。每小时监测胃内pH值是预防应激性出血的必要组成部分。抗酸剂是中和胃酸的首选药物，因为它更有效、更安全且成本更低。
