2019 年第 8 期 第 14 卷

雷贝拉唑治疗消化性溃疡的效果及对机体相关指标水平的影响

Effect of rabeprazole on peptic ulcer and relevant organism indexes

作者：张旭

英文作者：

单位：310012杭州，浙江医院急诊科

英文单位：

关键词：消化性溃疡；雷贝拉唑；奥美拉唑；胃泌素；血液流变学

英文关键词：

• 摘要：

• 【摘要】目的    探讨雷贝拉唑治疗消化性溃疡的效果及对血清Ⅰ型胶原氨基端前肽（PINP）、Ⅰ型前胶原羧基端肽β特殊序列（β-CTX）及转化生长因子β1（TGF-β1）的影响。方法    选取2014年8月至2016年9月浙江医院收治的消化性溃疡患者113例，根据随机数字表法分为对照组（55例）和观察组（58例）。对照组采用奥美拉唑联合阿莫西林、克林霉素治疗；观察组采用雷贝拉唑联合阿莫西林、克林霉素治疗。观察2组患者治疗前和治疗后幽门螺杆菌（Hp）根除率、症状积分情况、胃泌素、胃动素、血液流变学指标、PINP、β-CTX及TGF-β1水平变化情况。结果    治疗后观察组Hp根除率高于对照组［91.4%（53/58）比72.7%（40/55）］，差异有统计学意义（P<0.05）。治疗后2组症状积分均较治疗前下降，2组间差异无统计学意义［（6.8±1.2）分比（7.0±1.0）分］（P>0.05）。治疗后，2组患者胃泌素和胃动素水平均较治疗前下降，且观察组低于对照组［（82±12）ng/L比（102±14）ng/L、（359±13）ng/L比（390±16）ng/L］，差异均有统计学意义（均P<0.05）。治疗后，2组血浆黏度、红细胞沉降率、红细胞比容水平均较治疗前下降，且观察组低于对照组［（1.13±0.11）mPa·s比（1.56±0.13）mPa·s、（7.2±1.2）mm/1 h比（12.4±1.2）mm/1 h、（31±4）%比（37±5）%］，差异均有统计学意义（均P<0.05）。治疗后2组患者PINP水平较治疗前上升、且观察组高于对照组［（31.2±1.3）μg/L比（27.5±1.2）μg/L］，TGF-β1水平较治疗前下降、且观察组低于对照组［（812±80）ng/L比（1 025±102）ng/L］，差异均有统计学意义（均P<0.05）。β-CTX治疗前后组内、组间比较差异均无统计学意义（均P>0.05）。结论    雷贝拉唑治疗消化性溃疡疗效确切，可有效缓解患者临床症状，改善患者血液流变学指标，调节患者血清PINP和TGF-β1水平。

• 【Abstract】Objective    To explore the therapeutic efficacy of rabeprazole in treatment of peptic ulcer and its effect on serum procollagen type Ⅰ N-terminal propeptide(PINP), collagen type Ⅰ C-terminal peptide β-specific sequence(β-CTX) and transforming growth factor-β1(TGF-β1). Methods    Totally 113 patients with peptic ulcer patients admitted to Zhejiang Hospital from August 2014 to September 2016 were divided into control group(55 cases) and observation group(58 cases) according to random number table method. The control group was treated with omeprazole, amoxicillin and clindamycin; the observation group was treated with rabeprazole, amoxicillin and clindamycin. Eradication rate of Helicobacter pylori(Hp), symptom score, levels of gastrin, motilin, hemorheological indexes, PINP, β-CTX and TGF-β1 were analyzed. Results    Eradication rate of Hp in observation group was significantly higher than that in control group［91.4%(53/58) vs 72.7%(40/55)］(P<0.05). After treatment, symptom score significantly decreased and there was no significant difference between groups［（6.8±1.2） vs （7.0±1.0）］(P>0.05). Levels of gastrin and motilin significantly decreased after treatment in both groups; the levels in observation group were lower than those in control group［（82±12）ng/L vs （102±14）ng/L, （359±13）ng/L vs （390±16）ng/L］(all P<0.05). Plasma viscosity, erythrocyte sedimentation rate and erythrocrit significantly decreased after treatment; the indexes in observation group were lower than those in control group［（1.13±0.11）mPa·s vs （1.56±0.13）mPa·s, （7.2±1.2）mm/1 h vs （12.4±1.2）mm/1 h, （31±4）% vs （37±5）%］(all P<0.05). Serum level of PINP significantly increased and TGF-β1 level decreased after treatment; PINP level in observation group was higher and TGF-β1 level was lower than those in control group［（31.2±1.3）μg/L vs （27.5±1.2）μg/L, （812±80）ng/L vs （1 025±102）ng/L］(all P<0.05). There was no significant difference of serum β-CTX level between groups before and after treatment(all P>0.05). Conclusion    Rabeprazole treating peptic ulcer can effectively relieve clinical symptoms, improve hemorheological indexes, regulate serum PINP and TGF-β1 levels.