ABSTRACT
Objective To investigate the efficacy and safety of proton pump inhibitor in the treatment of stress ulcer.Methods 100 patients with stress ulcer were enrolled ,and they were randomly divided into two groups according to the random number table .The patients in the control group were treated with omeprazole .The patients in the observation group were treated with pantoprazole 40mg intravenous infusion,2 times/day,10 days after treatment, modified to rabeprazole 10mg,2 times /day,oral 6 weeks.The clinical symptoms score,ulcer area,the overall treat-ment,adverse reactions,recurrence rate and quality of life were compared between the two groups .Results After treatment,the clinical symptom score and ulcer area of the observation group were (8.87 ±2.55)points,(19.46 ± 6.88)mm,respectively,which were significantly lower than those of the control group [(12.68 ±3.14) points, (34.20 ±9.77)mm].The markedly effective rate and total effective rate of the observation group were 70%,88%, respectively,which were significantly higher than those of the control group (28%,66%).The recurrence rates of 6 months and 12 months of the observation group were 6% and 26%,respectively,which were significantly lower than those of the control group(28%,52%).The total score of quality of life after 12 months of treatment in the observa-tion group was (635.14 ±55.83)points,which was significantly higher than that of the control group [(578.94 ± 52.40)points,t =5.190,P <0.01].The incidence rate of overall adverse reaction had no statistically significant difference between the two groups (P >0.05).Conclusion Proton pump inhibitor is effective in the treatment of stress ulcer with high safety and has reference significance .
ABSTRACT
Objective To explore the related risk factors of cerebral hemorrhage complicated with stress ulcer (SU). Methods The clinical data of 1 185 patients with cerebral hemorrhage admitted to Department of Emergency Medicine of Nanjing General Hospital from March 2006 to March 2014 were retrospectively analyzed. Patients were divided into two groups according to whether patients complicated with SU or not. Data was collected within 8 hours after admission in two groups including gender,age,amount of bleeding,the bleeding site (basal ganglia,thalamus, brainstem,brain lobe,ventricle,subarachnoid,and cerebellum),disturbance of consciousness,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,systolic blood pressure(SBP),history of hypertension,and history of cerebral hemorrhage. The statistically significant risk factors found using univariate analysis was selected and was analyzed to find independent risk factors with multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve)was plotted to analyze the independent risk factors and evaluate their power of test. Results 1 185 patients with cerebral hemorrhage were enrolled in the study,293 cases occurred SU,accounting for 24.7%,and 892 cases without SU,which accounted for 75.3%. As shown by univariate analysis,risk factors for cerebral hemorrhage complicated with SU included age,amount of bleeding,the bleeding site,disturbance of consciousness,APACHEⅡscore,SBP. As to the site of bleeding,brain,thalamus,brainstem hemorrhage complicated with SU were higher proportion,45.3%(43/95),39.1%(63/161),36.9%(48/130),which were significantly higher than those of the lobes of the brain 〔26.2% (33/126)〕,cerebellum 〔18.8% (15/80)〕,basal ganglia〔16.1%(78/485)〕,arachnoid the inferior vena cava 〔12.0% (13/108)〕. Multivariate logistic regression analysis showed that amount of bleeding 〔odds ratio (OR)=3.305,P=0.001,95%confidence interval (95%CI)2.213-48.634〕,the bleeding site (OR=1.762,P=0.008,95%CI 0.123-2.743),SBP (OR=1.223,P=0.034,95%CI 0.245-2.812) were independent risk factors of cerebral hemorrhage complicated with SU. The area under the ROC curve (AUC)of amount of bleeding and SBP were 0.846 and 0.597,suggesting that amount of bleeding has moderate diagnostic value and SBP has low diagnostic value. Conclusions Cerebral hemorrhage patients with large amount of bleeding,the bleeding site in the ventricle,thalamus or brainstem,high SBP are of great risk. We should lower blood pressure and give preventive treatment for SU as soon as possible.