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[雷尼替丁对十二指肠溃疡出血的应激限制作用]

[Stress-limiting effect of zantac in duodenal ulcer bleeding].

作者信息

Ermolov A S, Pakhomova G V, Tveritneva L F, Golikov P P, Nikolaeva N Iu

出版信息

Vopr Med Khim. 1995 Sep-Oct;41(5):56-9.

PMID:8553632
Abstract

Two randomized groups of patients with ulcerative gastroduodenal hemorrhage were studied. One group of patients with bleeding-accompanied ulcerative disease of the stomach (n = 11) and the duodenum (n = 22) received the routine therapy, another group, including those of the same diseases (n = 9 and n = 22, respectively) had additionally the histamine H2-receptor blocking agent zontac by the following schedule: intravenously, 50 mg thrice a day within the first 3 days, and orally, 150-mg tablets twice a day within the following 3 weeks. Donors (n = 20) served as a control group for the zontac-treated and untreated patients. The stress-limiting effect of zontac was evaluated by the physicochemical parameters of corticosteroid-binding globulin, serum cortisole and insulin concentrations which were measured on days 1, 3, 7, and 14 following the first hemorrhage. In the zontac-treated group, the association constant of the blood cortisole-corticosteroid-binding globulin increased, while the dissociation constant decreased. At the same time the absolute and relative number of sites for binding of cortisole by means of corticosteroid-binding globulin also dropped to the values seen in the group of donors. Zontac caused a reduction in the cortisole/insulin ratio. This all suggests that zontac produces its stress-limiting effect in patients with ulcerative gastroduodenal hemorrhage. Zontac therapy decreased the need for surgical arrest of bleeding by 50% and the average day/bed.

摘要

对两组溃疡性胃十二指肠出血患者进行了随机研究。一组患有伴有出血的胃溃疡疾病(n = 11)和十二指肠溃疡疾病(n = 22)的患者接受常规治疗,另一组包括相同疾病的患者(分别为n = 9和n = 22),另外按照以下方案使用组胺H2受体阻滞剂善得胃:静脉注射,在头3天内每天3次,每次50毫克,在接下来的3周内口服150毫克片剂,每天2次。捐赠者(n = 20)作为善得胃治疗组和未治疗组患者的对照组。通过在首次出血后第1、3、7和14天测量的皮质类固醇结合球蛋白、血清皮质醇和胰岛素浓度的物理化学参数来评估善得胃的应激限制作用。在善得胃治疗组中,血皮质醇-皮质类固醇结合球蛋白的结合常数增加,而解离常数降低。同时,通过皮质类固醇结合球蛋白结合皮质醇的位点的绝对和相对数量也降至捐赠者组中的值。善得胃导致皮质醇/胰岛素比值降低。所有这些表明善得胃在溃疡性胃十二指肠出血患者中产生应激限制作用。善得胃治疗使手术止血的需求减少了50%,并减少了平均住院天数。

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