埃索美拉唑防治非甾体类抗炎药所致老年人上消化道出血的疗效观察

目的探讨早期应用埃索美拉唑防治非甾体类抗炎药（NSAIDs）所致老年人上消化道出血的疗效。方法将80例服用NSAIDs的老年人分为埃索美拉唑组（40例）和法莫替丁组（40例）,观察2组患者上消化道出血的发生率,监测给药后第2、4、6天胃液pH值。结果在埃索美拉唑组,34例患者无明显上消化道出血发生,5例发生少量出血,显效率为85.0%,总有效率为97.5%;在法莫替丁组,8例患者发生明显出血,13例发生少量出血,显效率为47.5%,总有效率为80.0%,2组比较,差异有统计学意义（P〈0.01）。治疗第2、4、6天,埃索美拉唑组胃液pH值均明显高于法莫替丁组（5.44±0.67比4.18±0.72、5.61±0.71比4.85±0.85、5.74±0.63比5.13±0.79,P均〈0.01）。结论早期应用埃索美拉唑可显著降低NSAIDs所致老年人上消化道出血的发生率,明显提高其胃液pH值。

Efficacy of esomeprazole on gastrointestinal bleeding caused by NSAIDs in the elderly

Objective To evaluate the effects of esomeprazole on gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs(NSAIDs) in the elderly. Methods Eighty elderly patients taking NSAIDs were divided into two groups: esomeprazole group(n=40) and famotidine group(n=40).The incidence of gastrointestinal bleeding was observed and the pH of gastric juice was detected 2 d,4 d and 6 d after administration. Results There were 34 cases with notobvious gastrointestinal bleeding in the esomeprazole group,and 5 cases with mild bleeding,while in the famotidine group,8 cases with marked bleeding and 13 cases with mild bleeding.The obvious effective rate and the general effective rate in esomeprazole group(85.0%,97.5%) were significantly higher than those in famotidine group(47.50%,80.0%,P<0.01).The pH of gastric juice on 2,4,6 d in esomeprazole group were significantly higher than those in famotidine group(5.44±0.67 vs 4.18±0.72,5.61±0.71 vs 4.85±0.85,5.74±0.63 vs 5.13±0.79,P<0.01 respectively). Conclusions The early administration of esomeprazole can effectively decrease the incidence of gastrointestinal bleeding caused by NSAIDs and can increase the pH of gastric juice in the elderly.