奥曲肽联合泮托拉唑钠治疗急性胰腺炎的效果观察

目的探讨奥曲肽联合泮托拉唑钠治疗急性胰腺炎的临床效果。方法选择本院92例急性胰腺炎患者．随机分为观察组和对照组,各46例,对照组给予乌司他丁、奥曲肽等常规治疗,观察组在对照组治疗基础上加用泮托拉唑钠治疗,观察两组患者治疗效果。结果观察组血淀粉酶、尿淀粉酶、血脂肪酶及血清钙恢复正常时间均短于对照组（P〈0．05）;观察组痊愈率为78．26％,显著高于对照组的52．17％（P〈0．05）;观察组患者发热、腹痛、腹胀、恶心呕吐等症状改善时间短于对照组（P〈0．05）;观察组患者治疗后IL-6、CRP及TNF-α水平均低于对照组（P〈0．05）。结论奥曲肽联合泮托拉唑钠治疗急性胰腺炎可减轻胰腺及周围组织损伤,改善炎症,从而加快机体恢复。提高治疗效果。     

瑞巴派特联合铋剂四联疗法治疗幽门螺杆菌阳性胃溃疡的临床研究

目的 探究瑞巴派特联合铋剂四联疗法治疗幽门螺杆菌（Hp）阳性胃溃疡的临床效果。方法 选取2020年7月—2022年7月广西壮族自治区胸科医院收治的112例Hp阳性胃溃疡患者,随机分为对照组和治疗组,每组各56例。对照组给予铋剂四联疗法,泮托拉唑钠肠溶片40 mg/次,2次/d;阿莫西林克拉维酸钾片1 g/次,2次/d;克拉霉素片500 mg/次,2次/d;枸橼酸铋钾胶囊0.3 g/次,3次/d。治疗组在对照组基础上口服瑞巴派特片,0.1 g/次,3次/d。两组均在治疗2周后停用抗生素,治疗时间均为4周。观察两组患者临床疗效,比较治疗前后两组患者Hp根除率,胃黏膜形态学指标,及血清干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、IL-4和IL-5水平。结果 治疗后,治疗组临床有效率（98.22%）和Hp根除率（98.22%）均分别显著高于对照组（87.50%,85.71%,P<0.05）。治疗后,两组患者胃黏膜形态学指标评分均较治疗前降低（P<0.05）,且治疗组慢性炎症细胞、腺体密度及黏膜后厚度评分均低于对照组（P<0.05）。治疗后,两组患者血清IFN-γ、I...     

泮托拉唑与奥美拉唑治疗消化性溃疡并出血临床分析

目的：比较泮托拉唑与奥美拉唑治疗消化性溃疡出血的疗效。方法：采用前瞻性研究方法,对2001年1月至2004年1月急诊的126消化性溃疡出血患者,随机分为泮托拉唑治疗组与奥美拉唑治疗组各63例,观察其疗效及不良反应_。结果：泮托拉唑组与奥美拉唑组的总有效率分别为92％(58／63)与95％(60／63),无显著性差异;且无明显不良反应发生。结论：泮托拉唑与奥美拉唑治疗消化性溃疡出血临床疗效相当,二者皆起效快、副作用小。     

两种质子泵抑制剂治疗幽门螺杆菌感染活动性胃溃疡的药物经济学评价

目的：应用药物经济学原理分析泮托拉唑与兰索拉唑治疗幽门螺杆菌（ Hp ）感染活动性胃溃疡成本-效果,寻找最佳治疗方案。方法：选择符合标准的患者100例,随机分为A组和B组各50例,A组应用泮托拉唑,B组应用兰索拉唑,其余治疗方案二者相同,疗程结束进行疗效评价。结果：A组患者临床治愈率80．00％,B组溃疡愈合率80．00％,差异无统计学意义（ P＞0．05）。 A组患者成本-效果比（C/E）为4．81,明显低于B组的5．81,增量成本-效果比（ΔC/ΔE）为68．33;敏感度分析A组患者C//E为4．33,明显低于B组的5．25,ΔC//ΔE为66．85。结论：泮托拉唑治疗幽门螺杆菌感染活动性胃溃疡较兰索拉唑具有更高的药物经济学价值。     

泮托拉唑与奥美拉唑治疗老年消化性溃疡出血疗效对比

目的：对比泮托拉唑和奥美拉唑对老年消化溃疡出血的临床疗效。方法将52例老年消化溃疡出血患者分为泮托拉唑组（28例,给予泮托拉唑）和奥美拉唑组（24例,给予奥美拉唑）,观察2组出血停止时间、胃液 pH、临床疗效,并进行成本-效果分析。结果泮托拉唑组患者出血停止时间短于奥美拉唑组,胃液pH 值高于奥美拉唑组,组间比较差异均有统计学意义（P<0.05）。泮托拉唑组总有效率96.4%（27/28）,奥美拉唑组91.7%（22/24）,奥美拉唑组成本明显高于泮托拉唑组,C/E 为13.046,△C/△E 为117.723。结论泮托拉唑用于老年患者消化溃疡出血疗效较好,不良反应少,医疗费用低,值得临床进一步研究推广。     

Intravenous pantoprazole utilization in a level 1 trauma center

Background In recent years there has been a rapid increase in the use of proton pump inhibitors. Our institution has recently had several shortages of IV pantoprazole, each lasting 7–10 days. The purpose of our study was to evaluate in-patient usage of IV pantoprazole. We hypothesized that hospitalized patients with upper gastrointestinal bleeding (GIB) or risk for stress ulcers inappropriately received IV pantoprazole based on current literature. Methods This was a retrospective study of 165 consecutive in-patients identified as receiving pantoprazole from December 2004 to March 2005. Only patients receiving IV pantoprazole were included (n = 78). Data collected included demographics, indication and dosing of pantoprazole, admitting team (surgery vs. medicine), and risk factors for stress ulcers. Results Our study population had a mean age of 54 ± 17 years and 62% were male. Overall, 45% (35/78) of patients receiving IV pantoprazole had an appropriate indication, and 19% (15/78) received the correct dose. Of the 78 patients, 43 (55%) were treated with pantoprazole for stress ulcer prophylaxis (SUP), and 35 (45%) patients were treated for GIB. We found that none of the 43 patients treated for SUP had an appropriate indication for pantoprazole, but all of the patients with GIB (35) had an appropriate indication. Of the 35 patients treated for GIB with pantoprazole, only 40% (14/35) received the correct dose. In all cases of incorrect dosing, the patients were underdosed. Conclusions Pantoprazole is not being prescribed appropriately for stress ulcer prophylaxis in our patient population. Even in patients appropriately receiving pantoprazole the majority were prescribed an incorrect dose. Appropriate indications and dosing of pantoprazole could eliminate the shortages seen at our institution.     

Structural identification and characterization of potential impurities of pantoprazole sodium

Six impurities in pantoprazole sodium bulk drug substance were detected by a simple high performance liquid chromatographic method (HPLC) whose area percentage ranged from approximately 0.05 to 0.34%. Liquid chromatography-mass spectrometry (LC-MS) was performed to identify the molecular weight of the impurities. A thorough study was undertaken to characterize these impurities. These impurities were synthesized, subsequently characterized and were co-injected with the sample containing impurities and found the retention time match of the spiked impurities. Based on their spectral data (IR, NMR and MS), these impurities were characterized as; 5-(difluoromethoxy)-2-[[(3,4-dimethoxy-2-pyridinyl)methyl]thio]-1H-benzimidazole (Impurity-I); 5-(difluoromethoxy)-2-[[(3,4-dimethoxy-2-pyridinyl)methyl]sulfonyl]-1H-benzimidazole (Impurity-II); 5-(difluoromethoxy)-2-[[(3,4-dimethoxy-1-oxide-2-pyridinyl)methyl]sulfonyl]-1H-benzimidazole (Impurity-III); 5-(difluoromethoxy)-2-[[(3,4-dimethoxy-2-pyridinyl)methyl]thio]-1-((3,4-dimethoxy-2-pyridinyl)methyl)-1H-benzimidazole (Impurity-IV); 5-(difluoromethoxy)-2-[[(3,4-dimethoxy-2-pyridinyl)methyl]sulfinyl]-1-((3,4-dimethoxy-2-pyridinyl)methyl)-1H-benzimidazole (Impurity-V); 5-(difluoromethoxy)-2-[[(3,4-dimethoxy-1-oxide-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole (Impurity-VI). The formation of these impurities was proposed. The structure of the Impurity-II was unambiguously confirmed by single crystal X-ray diffraction (XRD) studies.     

甘草酸铋散联合泮托拉唑治疗十二指肠溃疡的临床研究

目的探讨甘草酸铋散联合泮托拉唑钠肠溶片治疗十二指肠溃疡的临床疗效。方法选取2018年2月—2019年2月在天津市西青医院治疗的十二指肠溃疡患者88例,按照治疗方法的差别分为对照组(44例)和治疗组(44例)。对照组口服泮托拉唑钠肠溶片,40 mg/次,1次/d;治疗组在对照组基础上口服甘草酸铋散,1 g/次,3次/d。两组患者经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者症候积分、血清白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)、白细胞介素-23(IL-23)、血管内皮生长因子(VEGF)、高迁移率族蛋白1(HMGB1)、前列腺素E2(PGE2)、肾上腺髓质素(AM)、胃泌素(GAS)、生长抑素(SS)和降钙素基因相关肽水平(CGRP)水平,及GQOL-74量表评分。结果治疗后,对照组和治疗组临床有效率分别为81.82%和97.73%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者症候积分显著下降(P0.05),且治疗组患者这些症候积分明显低于对照组(P0.05)。治疗后,两组患者血清AM、GAS、IL-1β、IL-8、IL-23和HMGB1水平水平均明显下降(P0.05),而CGRP、SS、VEGF和PGE2水平均明显升高(P0.05),且治疗组患者这些细胞因子水平明显好于对照组(P0.05)。治疗后,两组患者GQOL-74量表评分均明显升高(P0.05),且治疗组患者GQOL-74量表评分明显高于对照组(P0.05)。结论甘草酸铋散联合泮托拉唑钠肠溶片治疗十二指肠溃疡可有效改善患者临床症状,降低机体炎症反应,促进溃疡愈合。     

3种拉唑类三联疗法治疗幽门螺杆菌感染的成本-效果分析

目的:探讨不同给药方案治疗幽门螺杆菌(Hp)感染的经济学效果。方法:102例Hp感染的消化性溃疡患者随机分为3组,给予奥美拉唑+阿莫西林+胶体果胶铋(A组)、雷贝拉唑+阿莫西林+胶体果胶铋(B组)、泮托拉唑+阿莫西林+胶体果胶铋(C组),采用成本-效果分析法进行评价。结果:A、B、C组的Hp清除率及溃疡愈合率的成本-效果比分别为1027.31、976.79、967.40及921.05、915.77、936.16。结论:B组方案较佳。