摘要
目的观察短期使用替普瑞酮对预防非甾体抗炎药(NSAIDs)所致消化道溃疡再出血的疗效,并分析患者外周血液CD4+、CD25+及Treg的水平变化。方法选择56例长期使用NSAIDs药物所致的消化道出血患者作为病例组,另外选择23例健康成年人作为对照组。病例组经胃镜喷洒止血药物后随机分为2组,其中替普瑞酮组28例,服用替普瑞酮50 mg/次,3次/d,同时加用奥美拉唑20 mg/次,2次/d,疗程共8周;奥美拉唑组单纯服用奥美拉唑20 mg/次,2次/d,共8周。观察两组患者8周内的不良反应、出血再发生率、随访40周后出血再发生率。另外,采用流式细胞术观察CD4+、CD25+及Treg细胞的表达水平。结果①替普瑞酮组、奥美拉唑组治疗8周后的再出血率分别为7.1%、21.4%,40周后再出血率分别为0、14.2%,两组比较差异有统计学意义(P<0.05),两组不良反应比较差异无统计学意义(P>0.05);②治疗前,病例组患者的CD4+、CD25+及Treg水平差异无统计学意义(P>0.05),但均明显高于对照组(P<0.05);治疗8周后,两个病例组CD4+、CD25+及Treg水平明显下降,但仍然高于对照组(P<0.05),替普瑞酮组较奥美拉唑组下降明显(P<0.05);40周后,替普瑞酮组CD4+、CD25+及Treg水平同对照组比较差异无统计学意义(P>0.05),奥美拉唑组仍然高于上述两组(P<0.05)。结论替普瑞酮联合奥美拉唑可以及时预防和治疗NSAIDs所致的溃疡和出血,效果优于单独使用质子泵抑制剂;同时,可以显著降低NSAIDs患者血中CD4+、CD25+及Treg水平,提高患者免疫力。
Objeetive To analyze the short-term efficacy of teprenone on preventing re-bleeding of ulcer induced by NSAIDs,and the CDM ＋,CD25 ＋ and Treg level changing in peripheral blood of patients.Methods 56 patients whose gastrointestinal bleeding were caused by long-term NSAIDs as case group,23 healthy adults as control group ;Hemostatic drugs will be sprayed by endoscopy in case group,then the 56 patients were randomly divided into two groups：teprenone group and omeprazole group,28 cases in each group.Teprenone group was given teprenone（50 mg,3 times daily） and omeprazole （20 mg,twice daily） ; Omeprazole group was given omeprazole （20 rmg,twice daily）.The treatment lasted for 8 weeks.The adverse reaction was observed within 8 weeks,the incidence of re-bleeding after 40 weeks were followed up,in addition,the peripheral CD4 ＋,CD25 ＋ and Treg cells were examined before and after treatment.The expression level of CD4 ＋,CD25 ＋ and Treg was observed and compared before and after treatment.Results ①The re-bleeding rates of teprenone group and omeprazole group after 8/40 weeks were 7.1％ and 21.4％,0 and 14.2％ respectively（P ＜ 0.05） ; and there was no significant difference in adverse reactions between the two groups （P ＞ 0.05） ; ②Before treatment,no significant difference in the level of CDM ＋,CD25 ＋ and Treg in the two cases groups was observed,but they were significantly higher than that of control group （P ＜ 0.05） ; 8 weeks after treatment,the CD4 ＋,CD25 ＋ and Treg level of the two case groups obviously decreased,there were significant differences between them,but still higher than those of control group（P ＜0.05） ;After 40 weeks,there was no significant difference in the CD4 ＋,CD25 ＋ and Treg level between teprenone group and control group,but omeprazole group was still higher than the above two groups.Conclusion Teprenone combined with omeprazole can timely prevent and treat the ulcer and re-bleeding caused by NSAIDs,the effect is better than single use of proton pump inhibitor; at the same time,it can significantly reduce the level of CDM ＋,CD25 ＋ and Treg in patients who took NSAIDs,improve the immunity of the patients.
出处
《实用药物与临床》
CAS
2013年第8期673-675,共3页
Practical Pharmacy and Clinical Remedies
