奥美拉唑与兰索拉唑预防危重病并发应激性溃疡的疗效及成本-效果分析

目的:对奥美拉唑与兰索拉唑预防危重病并发应激性溃疡的成本-效果进行分析,指导临床合理用药。方法:选择2010年1月至2013年12月入住张家界市人民医院重症医学科的危重病患者112例,按所用质子泵抑制剂的不同,使用随机数字表法随机分成奥美拉唑组(54例)、兰索拉唑组(58例),对两组患者的应激性溃疡发生率及成本-效果进行综合评价。结果:两组患者应激性溃疡的发生率分别为11.1%、12.1%,成本-效果比分别为2.33、6.28。结论:使用奥美拉唑预防危重病并发应激性溃疡的用药方案优于兰索拉唑预防危重病并发应激性溃疡的用药方案。     

兰索拉唑和雷贝拉唑对冠心病患者双重抗血小板治疗作用的影响

目的 探讨质子泵抑制剂（兰索拉唑和雷贝拉唑）对冠心病患者双重抗血小板治疗作用的影响.方法 选择接受双重抗血小板治疗的冠心病患者181例,其中66例患者未使用质子泵抑制剂治疗（对照组）,65例患者使用兰索拉唑治疗（兰索拉唑组）,50例患者使用雷贝拉唑治疗（雷贝拉唑组）.入选患者均服用阿司匹林100 mg/d和氯吡格雷75 mg/d.检测各组血小板聚集阈值（PATI）、二磷酸腺苷（ADP）和胶原蛋白诱导的血小板聚集率等指标.结果 对照组ADP-PATI为（3.47±0.96）μmol/L,兰索拉唑组为（3.28±1.05）μmol/L,雷贝拉唑组为（3.32±0.83）μmol/L,各组间比较差异无统计学意义（P＞0.05）.胶原蛋白-PATI、血小板聚集率各组间比较差异亦无统计学意义（P＞0.05）.结论 冠心病患者双重抗血小板治疗期间,联合应用兰索拉唑或雷贝拉唑治疗并不影响抗血小板作用.     

兰索拉唑对十二指肠溃疡治疗的疗效分析

[目的]探讨兰索拉唑治疗十二指肠溃疡的临床疗效。[方法]采用以质子泵抑制剂兰索拉唑为主要治疗药物的综合治疗方案治疗十二指肠溃疡,并与采用雷尼替丁治疗的对照组进行临床疗效和不良反应比较研究。[结果]治疗组患者中愈合32例,占88.89%,显效3例,占8.33%,有效1例,占2.78%,总有效率达100.00%;经统计分析发现治疗组的愈合率和总有效率均明显高于对照组,差异有统计学意义(P﹤0.05)。另外,36例治疗组中有33例患者的HP检查呈阴性,占91.67%;36例对照组中有28例患者的HP检查呈阴性,占77.78%,两组比较有明显差异,差异有统计学意义(P﹤0.05)。治疗组中出现口苦2例,便秘3例;对照组中口苦2例,腹胀2例;两组患者未出现其他严重的不良反应。两组比较差异无统计学意义(P﹥0.05)。[结论]在抗Hp及保护胃黏膜等常规治疗基础上加用兰索拉唑治疗活动性十二指肠溃疡显示出良好的临床效果,对十二指肠溃疡的愈合率及总有效率优于雷尼替丁,该药疗效好,且具有疗程短和Hp根除率高,安全性好,患者耐受性好等优点,值得临床推广应用。     

兰索拉唑联合莫沙必利对胆汁反流性胃炎作用的研究

目的:观察兰索拉唑、莫沙必利两药联合对胆汁反流性胃炎的疗效。方法:胆汁反流性胃炎患者随机分为4组:空白对照组(n=50)、兰索拉唑(n=50,兰索拉唑20mg,1次/d),莫沙必利组(n=50莫沙必利1.0g,3次/d)及联合用药组(n=50,兰索拉唑+莫沙必利,用法同上),疗程8周。观察各组患者腹痛、腹胀、烧心、口苦等症状改善情况。结果:治疗后三组治疗组患者症状均有所改善。结论:兰索拉唑和莫沙必利联用可有效治疗胆汁反流性胃炎。     

HPLC测定注射用兰索拉唑中兰索拉唑的含量

目的：研究注射用兰索拉唑制剂工艺,并采用高效液相色谱法建立其含量测定方法。方法：制备注射用兰索拉唑, AlltimaTM C18柱（4.6mm×250mm,5μm）;乙腈-水-三乙胺（40∶60∶1）（用磷酸调节pH值至7.0）为流动相;检测波长为285 nm。结果：制剂中辅料对主药测定无干扰,兰索拉唑在32.16～75.04μg/mL浓度范围内,峰面积与浓度呈良好的线性关系;精密度（RSD＝0.20%）良好;平均回收率为99.4%,RSD＝0.94%（n＝9）。结论：本方法简便、迅速、准确、专属性强,可用于注射用兰索拉唑的含量测定。     

兰索拉唑治疗胃食管反流病的疗效观察

目的评价兰索拉唑治疗胃食管反流病的疗效。方法选取2006年2月～2010年11月于笔者所在医院消化内科门诊就诊的并经胃十二指肠镜检查确诊的胃食管反流病患者120例,随机分为两组:治疗组予兰索拉唑30mg/次,1次/d,莫沙必利5mg/次,3次/d;对照组予奥美拉唑20mg/次,2次/d,多潘立酮10mg/次,3次/d。两组疗程均为4周。观察两组的临床症状缓解状况,复查胃十二指肠镜观察食管黏膜糜烂修复情况。结果两组治疗前后烧心、反流等症状评分下降比较差异有统计学意义(t=2.14,P<0.05);两组治疗4周内镜改善情况相比,治疗组与对照组治疗4周时内镜下改善与治疗前相比均有明显改善,治疗组较对照组愈合率、有效率明显增高,两组比较差异有统计学意义(x2=4.32,P<0.05)。结论兰索拉唑治疗GERD疗效肯定,明显优于奥美拉唑,而且不良反应少,可作为治疗GERD的常规方案。     

兰索拉唑联合二联抗生素治疗消化性溃疡46例临床分析

目的探讨兰索拉唑联合二联抗生素阿莫西林和克拉霉素治疗消化性溃疡的临床效果。方法选取94例2009年6月~2010年6月收治的消化性溃疡患者,随机分为治疗组和对照组,对照组48例,治疗组46例,对照组患者给予法莫替丁＋阿莫西林胶囊＋克拉霉素片＋麦滋林治疗;治疗组患者给予兰索拉唑＋克拉霉素＋阿莫西林胶囊＋麦滋林治疗,以7d为一疗程,共2个疗程。观察比较两组治疗效果及不良反应的发生率。结果治疗组总有效率达到97.8%,对照组的总有效率达到87.5%,两组差异具有统计学意义（P〈0.05）,两组患者均未出现肝肾功能损害现象,不良反应发生率也较低。停药后不良反应的现象均消失。结论兰索拉唑作为一种新型的质子泵抑制剂,其抑酸效果强大而持久,其配合二联抗生素克拉霉素和阿莫西林治疗消化性溃疡效果显著,比法莫替丁等H2受体疗效更为显著,且用药安全性高,值得借鉴。     

Pharmacokinetics of lansoprazole and its main metabolites after single intravenous doses in healthy Chinese subjects

1. The aim of the study was to evaluate the pharmacokinetics (PK) of lansoprazole (LPZ) and its main metabolites 5′-hydroxy lansoprazole (HLPZ) and lansoprazole sulphone (LPZS) after single intravenous (i.v.) doses of LPZ in healthy Chinese subjects, and the relationship between the cytochrome P450 (CYP) 2C19 phenotypes and the plasma concentrations of LPZS at the time-points in the elimination phase of LPZ.

2. Twelve subjects were given lansoprazole by i.v. infusion. Blood samples were collected at designated time points up to 24 h. Plasma concentrations of LPZ, HLPZ and LPZS were quantified by a selective and sensitive liquid chromatography-tandem mass spectrometric (LC-MS/MS) method.

3. After single i.v. doses of 15, 30 and 60 mg LPZ, C_max and area under the plasma concentration-time curve (AUC_0-t) of LPZ were 725 ± 151, 1480 ± 190, 3130 ± 480 µg·L^?1 and 1690 ± 1210, 3630 ± 2530, 8080 ± 4550 µg·h·L^?1, respectively. LPZ was generally well tolerated in healthy Chinese subjects, and displayed linear PK in the range of 15–60 mg.

4. There were significant differences in the elimination of LPZ and the formation of LPZS between the single CYP2C19 poor metabolizer (PM) and the CYP2C19 extensive metabolizers (EM). The concentration of LPZS at the time-points in the elimination phase of LPZ could be monitored for CYP2C19 phenotyping. As a probe drug for CYP2C19 phenotyping, LPZ for injection might be more suitable than LPZ oral formulations.

     

Intestinal CYP3A4 is not involved in the enantioselective disposition of lansoprazole

The contribution of (S)-lansoprazole to CYP3A4-catalysed sulfoxidation is greater than that of (R)-lansoprazole. The aim was to investigate the effect of grapefruit juice on the enantioselective disposition of lansoprazole among three CYP2C19 genotype groups. Eighteen healthy subjects, consisting of six each of homozygous extensive metabolizers (homEMs), heterozygous extensive metabolizers (hetEMs) and poor metabolizers (PMs), ingested a single oral dose of 60?mg racemic lansoprazole after taking either 200?ml grapefruit juice or water. There was no effect of grapefruit juice on the mean maximum plasma concentrations (C_max) or the elimination half-life for each lansoprazole enantiomer in all three CYP2C19 genotype groups. Similarly, the pharmacokinetic parameters of lansoprazole sulfone remained unaltered by grapefruit juice in all three groups. The CYP3A4-mediated first-pass sulfoxidation of (R)- and (S)-lansoprazole were not influenced by grapefruit juice. In addition, stereoselectivity of the intestinal CYP3A4-catalysed sulfoxidation of (R)- and (S)-lansoprazole was not observed.     

兰索拉唑联合莫沙必利、茴三硫治疗反流性食管炎的疗效观察

目的评价兰索拉唑联合莫沙必利、茴三硫治疗反流性食管炎的疗效。方法选择反流性食管炎患者120例,随机分3组,每组各40例。A组(莫沙必利组):兰索拉唑(15 mg,口服,bid)+莫沙必利(5 mg,口服,tid);B组(茴三硫组):兰索拉唑(15 mg,口服,bid)+茴三硫(25 mg,口服,tid);C组(联合治疗组):兰索拉唑(15 mg,口服,bid)+莫沙必利(5 mg,口服,tid)+茴三硫(25 mg,口服,tid),治疗时间均为8周。结果兰索拉唑联合莫沙必利、茴三硫治疗反流性食管炎的效果明显优于莫沙必利组及茴三硫组(P<0.05)。结论兰索拉唑联合莫沙必利、茴三硫治疗反流性食管炎有较好疗效,值得临床推广。