连续静脉注射法莫蒂丁治疗胃潰瘍出血
R P Walt1, J Cottrell, S G Mann
1Department of Medicine, Queen Elizabeth Hospital, Birmingham, UK.
Lancet (London, England)
|October 31, 1992
概括
作为一种强有力的胃酸抑制剂的法莫蒂丁在患有胃出血的患者中没有显著降低再出血或死亡率. 这项大型试验表明,抑制胃分泌不会改变这种疾病的自然过程.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 胃潰瘍出血可能危及生命,緊急手術帶有重大風險.
- 胃的pH影响血小板功能,凝血和素活性,这表明pH控制可能会影响出血.
- 之前对H2抗剂治疗出血的研究是有限的,尽管分析表明了潜在的临床益处.
研究的目的:
- 评估famotidine在减少活跃的胃潰瘍出血患者的复出血和死亡率方面的疗效.
- 为了确定保持接近中性的胃pH值是否会影响胃潰瘍出血的自然史.
主要方法:
- 一个大型的多中心随机对照试验,涉及1005名患有胃出血的患者.
- 患者在72小时内接受了静脉注射的法莫蒂丁 (10毫克大剂量,其次是3.2毫克/小时) 或匹配的安慰剂.
- 结果包括病例死亡率,再出血率和手术需要在各组之间进行了比较.
主要成果:
- 在病例死亡率方面没有发现显著差异 (6.2%的famotidine与5.0%的安慰剂).
- 再出血率 (23.9%的 famotidine 与 25.5%的安慰剂) 和手术率 (15.5%的 famotidine 与 17.1%的安慰剂) 也没有显著差异.
- 在治疗组中,famotidine疗法有效地保持了胃的pH值接近中性.
结论:
- 用法莫蒂丁强烈抑制胃分泌似乎不会影响胃出血的自然史.
- 这些发现表明,积极的酸性抑制可能不是管理活跃的胃潰瘍出血的关键因素.
- 可能需要进一步的研究来探索这种情况的替代或辅助疗法.
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