肝硬化大鼠肝部分切除术后肝再生的干预研究

目的　以肝硬化大鼠为动物模型 ,研究药物对肝硬化大鼠肝部分切除术后肝再生的影响。方法　取健康的Wistar雄性大鼠 6 4只 ,以 6 0 ?l4油溶液 0 .3ml/ 10 0 g皮下注射 ,同时饮用 5 %酒精溶液 ,4 5d后制成肝硬化动物模型。模型大鼠随机分为 4组 ,16只 /组。全麻下均行左、中叶肝切除术。术后各组按以下方案处理 :A组 (对照组 )注射生理盐水 1mg/ (kg·d) ,B组为泮托拉唑组 ,注射 0 .2mg/ (kg·d) ,C组为重组人生长激素组 ,注射 0 .5U/ (kg·d) ,D组为两药合用组 ,同时给予泮托拉唑注射 0 .2mg/ (kg·d) ,重组人生长激素注射 0 .5U/ (kg·d) ) ,连续给药 1周。抽取静脉血样 ,取肝脏组织 ,检测肝功能、有丝分裂指数 (MI)、增殖细胞核抗原 (PCNA)、细胞核DNA含量。结果　泮托拉唑组、重组人生长激素组、两药合用组MI、PCNA阳性染色细胞量、细胞核DNA含量均高于对照组 (P <0 .0 5 ) ,两药合用组MI、PCNA阳性染色细胞量、细胞核DNA含量均高于泮托拉唑组、重组人生长激素组 (P <0 .0 5 ) ,但各组间肝功能变化无明显差异。结论　泮托拉唑组及重组人生长激素均对肝硬化大鼠肝部分切除术后肝细胞再生有促进作用 ,两药联合应用肝细胞再生更明显 ,其详细机制须待进一步研究。     

泮托拉唑与奥美拉唑治疗消化性溃疡的疗效比较

目的:观察并比较泮托拉唑与奥美拉唑治疗消化性溃疡的疗效和安全性.方法:将56例经内镜确诊的消化性溃疡患者随机分为两组,治疗组28例,静脉滴注泮托拉唑钠40 mg,对照组28例,静脉滴注奥美拉唑钠40 mg,均为2次/d,疗程3～5 d,此后两药均改口服,20 mg/次,1次/d,连续4周.结果:治疗后治疗组与对照组溃疡愈合率分别为76.9%和73.9%,总有效率分别为92.9%和96.4%,组间比较无显著性差异(P＞0.05);两组不良反应均轻微.结论:泮托拉唑治疗消化性溃疡具有良好的疗效,值得临床推广应用.     

Routine application of the proton-pump inhibitor pantoprazole in patients with gastric lymphoma undergoing chemotherapy

Objective. The stomach is the most common site of origin for extranodal lymphomas. While resection has played a major part in the management of such patients in the past, in recent years there has been a change towards organ-conserving therapies. However, the risk of perforation and bleeding in patients undergoing organ-conserving therapy has been used as an argument against primary application of chemotherapy. In this article, we present our experience with the prophylactic use of oral pantoprazole. Material and methods. All patients undergoing chemotherapy for gastric lymphoma at our institution were prophylactically given oral pantoprazole (2×40 mg) for the duration of chemotherapy. Compliance with intake of the proton-pump inhibitor (PPI) was assessed at every visit for application of chemotherapy and at routine blood counts taken 10–14 days after each cycle of treatment by direct questioning of the patient. Results. A total of 82 patients (median age 69 years, range 33–93) received chemotherapy for gastric lymphoma: 51 had diffuse large B-cell lymphoma (DLBCL), 24 had mucosa-associated lymphoid tissue (MALT) lymphoma and 7 had DLBCL?+?MALT lymphoma. Compliance with intake of the PPI was excellent, as only two patients reported irregular intake and only one patient refused regular medication with pantoprazople. All patients responded to chemotherapy, with 74 (90%) achieving complete remission and 8 (10%) partial remission. After a median follow-up time of 50 months (range: 9–84 months) only one of these 82 patients (1.22%), the patient who discontinued intake of pantoprazole, died from gastric perforation, while none of the other patients had gastrointestinal bleeding or perforation. Conclusions. Judging from these data, continuous PPI intake is feasible and has a high rate of compliance. In the absence of randomized trials, routine application of oral pantoprazole in patients given chemotherapy for gastric lymphoma, especially DLBCL, appears to be a reasonable approach.     

Long-term management of GERD in the elderly with pantoprazole

The prevalence of gastroesophageal reflux disease (GERD) increases with age and elderly are more likely to develop severe disease. Older patients often complain of less severe or frequent heartburn than younger patients and they may present with atypical symptoms such as dysphagia, weight loss, or extraesophageal symptoms. Proton pump inhibitors (PPIs) are central in the management of GERD and are unchallenged with regards to their efficacy. They are considered safe and more effective than histamine receptor antagonists for healing esophagitis and for preventing its recurrence using a long term maintenance treatment. PPI have minimal side effects and few slight drug interactions and are considered safe for long term treatment. Pantoprazole is significantly effective both for acute and long-term treatment with excellent control of relapse and symptoms. It is well tolerated even for long-term therapy and its tolerability is optimal. Pantoprazole shows to have minimal interactions with other drugs because of a lower affinity for cytocrome P450 than older PPIs. Although the majority of elderly has concomitant illnesses and receive other drugs, this does not adversely effect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of patient age. Clinical practice suggests that a low dose maintenance of PPIs should be used in older patients with GERD.     

药学干预促进泮托拉唑注射剂在内科的合理使用

目的探讨药学干预对泮托拉唑注射剂在内科使用的影响,促进泮托拉唑在临床的合理使用。方法分析2013-01-03（药学干预前,对照组）和7-9月（药学干预后,观察组）泮托拉唑注射剂在内科的使用情况。结果经过干预,泮托拉唑注射剂的不合理使用率从37.3%下降到10.0%（P〈0.05）,内科医生对泮托拉唑合理使用的知晓率由80.2%上升到92.5%（P〈0.05）,患者对医疗服务的满意度由60.5%上升到87.3%（P〈0.05）,均具有统计学差异。结论药学干预可提高泮托拉唑在内科的合理使用,提高内科医生对泮托拉唑的知晓率和患者对医疗服务的满意度。     

低钾状态下泮托拉唑致小鼠缓慢型心律失常

目的探讨低钾状态下泮托拉唑(PPZ)致小鼠心律失常的机制。方法将小鼠随机分为4组:对照组、PPZ组[20 mg/(kg·d),腹腔注射5周]、低钾组[FS组,用呋塞米(FS)复制小鼠低钾模型]和低钾泮托拉唑组(FS+PPZ组),每组各20只。第5周末监测各组小鼠心电参数(HR、PR间期、QRS间期和QTc间期)和自发性心律失常的发生。荧光定量PCR和Western blot检测超级化激活环核苷酸门控阳离子通道2和4(HCN2和HCN4)、电压门控性Na+通道α亚基(SCN5A)、L型Ca^2+通道α1C亚基(CACNA1C)及T型Ca^2+通道α1G亚基(CACNA1G)mRNA和蛋白表达。结果与对照组比较,PPZ组HR降低和PR间期延长(P<0.01和P<0.05);与FS组比较,FS+PPZ组HR和PR间期均进一步降低和延长(P<0.01和P<0.05),有4只小鼠出现窦性停搏(P<0.05)。PPZ组较对照组HCN4 mRNA和蛋白水平均表达下降(P<0.01),FS+PPZ组较FS组进一步降低(均P<0.01);PPZ组较对照组HCN2仅mRNA水平表达下降(P<0.05),FS+PPZ组较FS组进一步降低(P<0.01)。结论在低钾状态下泮托拉唑可导致小鼠缓慢型心律失常,可能与HCN2和HCN4基因表达异常有关。     

消化内镜氩离子凝固术后不同黏膜保护剂应用的对比研究

目的:探讨不同黏膜保护剂在上消化道黏膜隆起病变内镜下氩离子凝固术后的临床应用效果.方法:选取西安市第一医院2018年6月-2020年6月行内镜下氩离子凝固术的240例患者,术后随机分为A、B、C、D组,每组60例.A组单独使用PPI制剂泮托拉唑;B组使用康复新液+泮托拉唑;C组使用硫糖铝混悬凝胶+泮托拉唑;D组使用胶体...     

泮托拉唑与兰索拉唑治疗胃溃疡的药物经济学分析

目的评价泮托拉唑与兰索拉唑治疗胃溃疡的药物经济学效果。方法选取本院2010年7月—2012年7月消化内科收治的胃溃疡患者83例,采用随机数字表法分为观察组(n=43)和对照组(n=40),分别给予泮托拉唑和兰索拉唑治疗。比较2组患者临床改善总有效率、不良反应发生率、总治疗费用、成本-效果等指标。结果观察组与对照组临床改善总有效率分别为93.03%和95.00%,不良反应发生率分别为27.91%和27.50%,2组患者临床改善总有效率及不良反应发生率比较差异均无统计学意义(P>0.05);观察组与对照组成本-效果指标分别为4.99和5.57;与观察组相比,对照组治疗成本更高。结论在胃溃疡治疗中,泮托拉唑方案的药物经济学价值高于兰索拉唑方案。     

顶空气相色谱法测定泮托拉唑钠中残留的有机溶剂

目的:建立泮托拉唑钠中5种有机溶剂的分离测定方法。方法:采用顶空进样毛细管气相色谱法,FID 检测器,应用 AT-1毛细管柱(30.0m×0.32mm×1μm),载气为氮气,柱温采取程序升温,初始温度40℃,保持4min,再以20℃·min~(-1)的速率升至150℃,保持3min,测定了泮托拉唑钠原料中丙酮、乙醚、二氯甲烷、三氯甲烷、甲苯的残留量。结果:各有机溶剂均能得到有效分离,在所考察的浓度范围内线性关系良好,r 为0.990～0.999,平均回收率为99.3%～105%。结论:本方法灵敏、准确、可靠,可用于泮托拉唑钠中有机溶剂的检测。     

泮托拉唑在不同CYP2C19基因型国人体内的药动学

 目的研究CYP2C19基因型对泮托拉唑中国健康志愿者体内药动学的影响。方法采用聚合酶链限制性片断长度多态性(PCR-RFLP)分析CYP2C19基因型。24名健康志愿者按照基因型划分的基因表型被随机分为3组(每组8名),纯合子强代谢型组(homEMs),杂合子强代谢型组(hetEMs),弱代谢型组(PMs)。受试者单剂量po 40mg泮托拉唑肠溶片后血药浓度的测定采用高效液相色谱法。结果HomEMs,hetEMs,PMs3组个体内的泮托拉唑的主要药动学参数如下:ρ_max为(2551.8±1035.2),(3316.63±1237.27)和(4256.04±573.47)μg·L^-1;t_max为(3.38±0.92),(3.25±1.54)和(3.50±0.96)h;t_1/2Ke为(1.82±1.71),(1.34±0.22)和(5.83±3.28)h;AUC_0～t为(5616.37±1878),(8132.22±3549.4)和(24882.71±7051.33)μg·h·L^-1;AUC_0～∞为(5699.5±1932.1),(8238.5±3513.3)和(32394.9±12428.3)μg·h·L^-1。HetEM组和PM组的受试者其泮托拉唑的ρ_max高于homEM组(P<0.01),PM组的t_1/2Ke要长于homEM组(P<0.01)。AUC_0～t和AUC_0～∞在PM组要分别高于homEM组和hetEM组(P<0.01),但在homEM组和hetEM组之间没有差异。结论泮托拉唑药动学在个体之间的差异与CYP2C19的基因型有关。