埃索美拉唑静脉滴注治疗非静脉曲张性上消化道出血的疗效观察

目的：评估埃索美拉唑40mg静脉注射治疗急性非静脉曲张性上消化道出血的疗效和安全。方法：对内镜证实的25例急性非静脉曲张性上消化道出血征象的患者，随机、双盲分为埃索关拉唑组（n=19）和奥美拉唑组（n=6），实验组和对照组分别给予埃索美拉唑和奥美拉唑40mg q12h静脉滴注，治疗5d。观察72h及120h的临床止血疗效及药物不良事件。结果：治疗72h两组临床上无消化道出血征象受试者百分率无显著性差异（P〉0．05）。治疗120h有效率两组均为100％。中位止血时间埃索关拉唑组为41h，奥美拉唑组为20h，两组比较无显著性差异（P〉0．05）。不良事件发生情况两组相似，均无与药物有关的严重不良事件发生。结论：静脉给予埃索美拉唑治疗急性非静脉曲张性上消化道出血疗效不劣于奥美拉唑，和奥美拉唑相比也有很好的耐受性。

Clinical Evaluation of Esomeprazole for Patients with Non-variceal Upper Gastrointestinal Bleeding

OBJECTIVE： To evaluate the therapeutic efficacy and safety of Esomeprazole （40 mg i.v） in patients with acute upper gastrointestinal bleeding. METHODS： 25 patients with signs of upper gastrointestinal bleeding endoscopically were randomized to receive either Esomeprazole （n = 19） or Omeprazole （n = 6） 40 rng intravenously q12h for five days. The primary efficacy endpoint was clinical hemostatic effects in 72 h and 120 h after the initial injection, respectively. RESULTS： No significant difference was found between Esomeprazole and Omeprazole groups for the proportion of patients with no clinically significant upper gastrointestinal bleeding within 72 （P 〉 0.05 ）. The effective rates in both groups after treatment for 120 hours were all 100%. The median hemostatie time was 41 hours in Esomeprazole group compared with 20 hours in Omeprazole group and no significant difference was found between the two groups （ P 〉 0.05 ）. In addition, no severe adverse event was observed in both groups. CONCLUSION： Esomeprazole for injection is not inferior to omeprazole in management of non-variceal upper gastrointestinal bleeding and both are well tolerated in patients.