Six-month management of patients following treatment for gastroesophageal reflux disease symptoms -- a Norwegian randomized, prospective study comparing the costs and effectiveness of esomeprazole and ranitidine treatment strategies in a general medical practitioners setting

This study assesses the difference in direct medical costs between on-demand treatment with esomeprazole 20 mg, continuous treatment with esomeprazole 20 mg once-daily and continuous treatment with ranitidine 150 mg twice-daily to prevent symptomatic relapse in patients with gastroesophageal reflux disease over 26 weeks. Two hundred eighty-one GP clinics in Norway enrolled 2156 patients to an open, randomized, parallel group, Norwegian society perspective study during 2000-2001. The total direct medical costs of each strategy were 171.9 Euros for on-demand esomeprazole (n = 634), 221.6 Euros for ranitidine (n = 610) and 248.8 Euros for continuous esomeprazole (n = 658). The total costs for on-demand and continuous esomeprazole treatment and ranitidine treatment were 221.5, 286.5 and 295.8 Euros, respectively. The highest proportion of costs was because of the study medication cost in each strategy. The on-demand and continuous treatment strategies with esomeprazole were found to be cost-effective, compared with ranitidine.     

艾司奥美拉唑在肝胆外科围术期的合理应用分析

目的 了解东方肝胆外科医院（简称"我院"）注射用艾司奥美拉唑钠在肝胆外科围术期应用的合理性,为肝胆手术围术期合理用药提供参考。方法 用回顾性研究方法,通过查阅电子病历、医嘱和检验结果等途径,随机采集了2017年1月至9月300例使用注射用艾司奥美拉唑钠患者的相关信息。300例病例艾司奥美拉唑的使用频次为416次,从给药时间、用药疗程、用法用量、溶剂和应激性溃疡危险因素等方面进行分析。结果 给药时间的合理率是15.67%（47/300）,用药疗程的合理率是10.67%（32/300）,用法的合理率是75%（312/416）,用量的合理率是100%（416/416）,溶媒的合理率为100%（416/416）,具有应激性溃疡危险因素的患者占3.33%（10/300）。结论 我院肝胆外科围术期应用艾司奥美拉唑合理性有待提高,临床药师应加强临床用药教育以提高合理用药水平。     

埃索美拉唑联合抗菌药物治疗十二指肠溃疡临床观察

目的探讨治疗十二指肠溃疡的临床有效方法。方法选取临床收治的212例十二指肠溃疡患者作为研究对象,根据患者临床治疗方法的不同分为治疗组和对照组。对照组给予埃索美拉唑治疗,治疗组给予埃索美拉唑、呋喃唑酮及阿莫西林联合治疗。观察和比较2组患者实施治疗后的临床治疗效果、幽门螺杆菌的根除效果和不良反应发生情况。结果临床治疗总有效率与幽门螺杆菌根除率,治疗组均高于对照组,差异具有统计学意义。结论埃索美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡,可在临床应用和推广。     

国产与进口法莫替丁片治疗非糜烂性胃食管反流病的经济学评价

目的比较国产与进口法莫替丁片治疗非糜烂性胃食管反流病（NERD）的经济性及疗效。方法将50例NERD患者分成观察组和对照组。对照组用进口法莫替丁片＋埃索美拉唑镁肠溶片＋西沙必利片,观察组用国产法莫替丁片＋埃索美拉唑镁肠溶片＋西沙必利片。结果观察组治愈率为68.00%,有效率为28.00%,无效率为4.00%,总有效率为96.00%;对照组治愈率为72.00%,有效率为20.00%,无效率为8.00%,总有效率为92.00%。两组间疗效比较,差异均无显著性（P〉0.05）。两组患者均未见明显不良反应。法莫替丁片国产价格低于进口。结论国产法莫替丁片联合埃索美拉唑镁肠溶片及西沙必利片治疗NERD疗效可靠,安全,经济实惠。     

埃索美拉唑与奥美拉唑三联疗法治疗胃溃疡临床对照研究

目的对比埃索美拉唑与奥美拉唑三联疗法治疗胃溃疡的疗效及安全性。方法将72例胃溃疡活动期且幽门螺杆菌阳性患者随机分为A组和B组,均口服阿莫西林克拉维酸钾片0．457g及替硝唑片0．5g、每日1次,A组（34例）再口服埃索美拉唑镁肠溶片20mg,B组（38例）再口服奥美拉唑镁肠溶片20mg,均每日1次。治疗8周后,A组和B组分别继续单服埃索美拉唑20mg或奥美拉唑20mg,每日1次,继续治疗4周后复查胃镜并检测幽门螺杆菌、血清c-反应蛋白、白细胞介素6。结果A组和B组患者幽门螺杆菌根除率分别为85．29％和73．68％,溃疡愈合率分别为91．18％和71．05％;两组治疗后血清炎症因子c-反应蛋白、白细胞介素6均较治疗前显著降低（P〈0．01）,且A组更明显（P〈0．05）。结论埃索美拉唑联合阿莫西林克拉维酸钾和替硝唑,较奥美拉唑三联疗法有更高的幽门螺杆菌根除率及溃疡愈合率,能更好地降低血清炎症因子水平,且不良反应少,值得临床推广。     

大剂量埃索美拉唑治疗急性非静脉曲张性上消化道出血疗效观察

目的观察大剂量埃索美拉唑在治疗急性非静脉曲张性上消化道出血的疗效及安全性。方法将74例急性非静脉曲张性上消化道出血患者随机分成2组,其中治疗组38例,给予首剂80 mg埃索美拉唑静脉注射,然后以8 mg/h的滴速持续滴注;对照组36例,给予埃索美拉唑40 mg静脉滴注,每12小时1次。72 h后评价2组病例的止血时间、再出血情况、输血量及不良反应。结果 2组不良反应发生率无明显差异,但治疗组止血率、止血时间、再出血发生率、平均输血量均优于对照组。结论大剂量埃索美拉唑治疗急性非静脉曲张性上消化道出血与常规剂量相比疗效明显,且起效迅速,安全可靠,再出血少,适用于大出血患者。     

Ethnic differences in drug therapy: a pharmacogenomics perspective

This study was presented at the American College of Chest Physicians meeting in Pittsburgh (PA, USA) in October 2011. The study objective was to evaluate the association of proton pump inhibitors (PPIs) and community-acquired pneumonia (CAP). The design was a meta-analysis of nine case–controlled and cohort studies. 120,863 pneumonia cases from 1987 to 2006 were included in the meta-analysis. PubMed and Ovid Medline were searched from inception through May 2011 by two investigators independently using keywords: PPI, pneumonia, CAP, anti-ulcer, antacid, omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole. This meta-analysis only included case–controlled and cohort studies that were published in full in English and evaluated PPI use and CAP incidence. Studies were excluded if they included the following patients: pediatric, Helicobacter pylori treatment and critically ill. Bibliographies of recent review articles and systematic reviews were hand-searched. Quality of studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. Two investigators independently extracted data into standardized data collection forms that were confirmed by a third investigator. Data were analyzed based on current use of PPIs, duration of PPI use (<30 days or >180 days) and PPI dose (high vs low). Overall association of PPI and CAP was analyzed using the random effects model (Comprehensive Meta analysis^® Version 2.0). Nine studies met all criteria for the primary outcome. Newcastle–Ottawa Quality Assessment Scale scores ranged from 4 to 8 out of 9. Current use of PPIs (odds ratio [OR]: 1.39; 95% CI: 1.09–1.76), PPI use <30 days (OR: 1.65; 95% CI: 1.25–2.19), PPI high dose (OR: 1.50; 95% CI: 1.33–1.68) and PPI low dose (OR: 1.17; 95% CI: 1.11–1.24) were significantly associated with CAP. There was no association between CAP and PPI use >180 days (OR: 1.10; 95% CI: 1.00–1.21). In conclusion, patients currently receiving PPIs, particularly <30 days or high dose, showed an association with CAP. Practitioners need to be vigilant about adverse effects of PPIs and consider alternative therapies.     

内镜下组织黏合剂联合埃索美拉唑治疗上消化道溃疡出血的疗效

目的探讨内镜下注射组织黏合剂联合埃索美拉唑治疗上消化道溃疡出血的疗效。方法 96例上消化道溃疡出血患者,按照入院先后顺序分为观察组(M组)和对照组(N组),每组48例。M组给予内镜下注射组织黏合剂联合埃索美拉唑,N组给予静脉点滴埃索美拉唑联合口服去甲肾上腺素。比较2组首次止血成功率和再出血率及并发症发生情况。结果 M组首次止血成功率(100.0%)明显高于N组(87.5%),再出血率(2.1%)明显低于N组(10.4%)(均P<0.05);2组均无异位栓塞、胃食管穿孔发生,均无死亡病例。结论内镜下注射组织黏合剂联合埃索美拉唑治疗上消化道溃疡出血,效果显著,操作简单,并发症少。     

埃索美拉唑对氯吡格雷高维持量作用的影响

目的评价埃索美拉唑对非ST段抬高急性冠脉综合征(NSTE-ACS)患者支架置入术后应用氯吡格雷效果的影响。方法将102例患者随机均分为对照组和埃索美拉唑组,出院时均给予阿司匹林75 mg和氯吡格雷150 mg长期口服,埃索美拉唑组另给予埃索美拉唑20 mg口服,每日2次。以磷酸化血小板血管扩张剂刺激磷蛋白(VASP)磷酸化程度计算的血小板反应指数(PRI)用于评估氯吡格雷效果和对二磷酸腺苷(ADP)诱导的血小板聚集反应性(ADP-Ag)。结果随访1个月,埃索美拉唑组患者血小板氯吡格雷反应性与对照组有同样的效果,PRI VASP为(37.3±5.8)%对(39.4±6.3)%,P>0.05;血小板聚集反应性埃索美拉唑组与对照组有同样的效果,ADP-Ag为(51.3±14.6)%对(52.7±15.3)%,P>0.05。结论对于接受氯吡格雷治疗且同时需要质子泵抑制剂治疗时,建议应尽可能选择对CYP2C19抑制效力小的埃索美拉唑。     

埃索美拉唑、左氧氟沙星与奥硝唑联用治疗慢性胃炎效果

目的观察埃索美拉唑、左氧氟沙星与奥硝唑联用治疗幽门螺杆菌阳性慢性胃炎病人的效果及安全性。方法选取97例幽门螺杆菌阳性慢性胃炎病人,随机分为治疗组50例与对照组47例。治疗组采用埃索美拉唑、左氧氟沙星与奥硝唑治疗;对照组采用埃索美拉唑、克拉霉素、阿莫西林治疗,均治疗7d,疗程结束4～6周后行^13C-尿素呼气试验检查。结果治疗组和对照组的幽门螺杆菌根治率分别为82．00％和63．83％,两组比较差异有显著性（χ^2=4．08,P〈0．05）。结论埃索美拉唑、左氧氟沙星与奥硝唑联用治疗幽门螺杆菌阳性慢性胃炎病人效果可靠,安全性好。