胃溃疡患者血管活性肠肽水平对兰索拉唑临床应用疗效的影响
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摘要
目的探讨胃溃疡患者血清血管活性肠肽(vasoactine intrestinal peptide,VIP)水平对兰索拉唑临床应用疗效的影响。方法选取2013年2月~2015年12月间右江民族医学院附属医院消化内科诊治的79例胃溃疡患者为研究对象,所有患者均予以兰索拉唑、果胶铋胶囊、甲硝唑和阿莫西林联合治疗,每周为1个疗程,持续3个疗程;采用放射免疫法测定治疗前血清VIP水平,以VIP测得值的中位数120.36pg/ml为分界值,≤120.36pg/ml的为低VIP组(40例),>120.36pg/ml的为高VIP组(39例),比较两组患者的临床疗效指标变化。结果两组患者在年龄、性别、体重指数、溃疡直径和平均病程方面的比较,差异均无统计学意义(P>0.05);高VIP组患者的总体有效率为94.87%,显著高于低VIP组的77.50%,差异有统计学意义(χ2=4.972,P=0.026);而且,高VIP组疼痛、烧灼感、恶心、呕吐、嗳气和腹胀的评分值也均显著低于低VIP组,差异有统计学意义(P<0.05)。结论血清VIP水平在胃溃疡发病中发挥重要作用,且兰索拉唑对高VIP水平胃溃疡患者的临床疗效更佳。
Objective To investigate the effects of serum vasoactive intestinal peptide( VIP) on the clinical efficacy of lansoprazole in patients with gastric ulcer. Methods The 79 cases of gastric ulcer were selected in the Department of digestive medicine,Youjiang Medical College For Nationalities from February 2013 to December 2015. All patients were treated with lansoprazole,pectin bismuth capsules,metronidazole and amoxicillin,1 course for each week and lasted for continuous 3 courses. The levels of serum VIP were measured by radioimmunoassay,the VIP median 120. 36 pg/ml was set as the cutoff value. The patients with VIP level less than 120. 36 pg/ml were set into low VIP group( 40 cases) and the VIP level more than 120. 36 pg/ml were set into high VIP group( 39 cases) and,and the changes of clinical curative effect indexes were compared between the two groups. Results There were no significant differences on age,sex,body mass index,ulcer diameter and mean duration of disease between the two groups( P > 0. 05); The overall clinical efficacy rate in the high VIP group was 94. 87%,which was significantly higher than that of low VIP group at 77. 50%( χ2= 4. 972,P = 0. 026); Moreover,the scores of pain,burning sensation,nausea and vomiting,belching and abdominal distention in the high VIP group was significantly lower than that of low VIP group( P < 0. 05). Conclusion The serum VIP plays an important role in the development of gastric ulcer,and the clinical efficacy of lansoprazole on gastric ulcer of high VIP patients is much better.
Objective To investigate the effects of serum vasoactive intestinal peptide( VIP) on the clinical efficacy of lansoprazole in patients with gastric ulcer. Methods The 79 cases of gastric ulcer were selected in the Department of digestive medicine,Youjiang Medical College For Nationalities from February 2013 to December 2015. All patients were treated with lansoprazole,pectin bismuth capsules,metronidazole and amoxicillin,1 course for each week and lasted for continuous 3 courses. The levels of serum VIP were measured by radioimmunoassay,the VIP median 120. 36 pg/ml was set as the cutoff value. The patients with VIP level less than 120. 36 pg/ml were set into low VIP group( 40 cases) and the VIP level more than 120. 36 pg/ml were set into high VIP group( 39 cases) and,and the changes of clinical curative effect indexes were compared between the two groups. Results There were no significant differences on age,sex,body mass index,ulcer diameter and mean duration of disease between the two groups( P > 0. 05); The overall clinical efficacy rate in the high VIP group was 94. 87%,which was significantly higher than that of low VIP group at 77. 50%( χ2= 4. 972,P = 0. 026); Moreover,the scores of pain,burning sensation,nausea and vomiting,belching and abdominal distention in the high VIP group was significantly lower than that of low VIP group( P < 0. 05). Conclusion The serum VIP plays an important role in the development of gastric ulcer,and the clinical efficacy of lansoprazole on gastric ulcer of high VIP patients is much better.
引文
1 Thorsen K,Reide JA,Kval YJT,et al.Epidemiology of perforated peptic ulcer:age-and gender-adjusted analysis of incidence and mortality[J].World J Gastroenterol,2013,19(3):347-354
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3 Ahn JY,Choi CH,Lee JW,et al.The effect of sequential therapy with lansoprazole and ecabet sodium in treating iatrogenic gastric ulcer after endoscopic submucosal dissection:a randomized prospective study[J].JDigestDis,2015,16(2):75-82
4 Martínez C,Ortiz AM,Juarranz Y,et al.Serum levels of vasoactive intestinal peptide as a prognostic marker in early arthritis[J].PLo S One,2014,9(1):e85248
5 郑冬梅.奥美拉唑、泮托拉唑、兰索拉唑治疗胃溃疡疗效比较[J].现代中西医结合杂志,2014,23(22):2461-2463
6 Sreide K,Thorsen K,Sreide J A.Strategies to improve the outcome of emergency surgery for perforated peptic ulcer[J].British J Surg,2014,101(1):e51-e64
7 Mhaskar RS,Ricardo I,Azliyati A,et al.Assessment of risk factors of helicobacter pylori infection and peptic ulcer disease[J].J Global Infectious Dis,2013,5(2):60-67
8 JoséR Martinez Aranzalez,Geraldo E Silveira Alves.Equine gastric ulcer syndrome:risk factors and therapeutic aspects[J].Revista Colombiana De Ciencias Pecuarias,2014,27(3):157-169
9 Gona SK,Alassan MK,Marcellin KG,et al.Postoperative morbidity and mortality of perforated peptic ulcer:retrospective cohort study of risk factors among black Africans in c8te d'ivoire[J].Gastroenterol Res Practice,2016,2016(2):1-7
10 Ahn JY,Choi CH,Lee JW,et al.The effect of sequential therapy with lansoprazole and ecabet sodium in treating iatrogenic gastric ulcer after endoscopic submucosal dissection:a randomized prospective study[J].J Digest Dis,2015,16(2):75-82
11 Kitagawa T,Sato K,Yokouchi Y,et al.A case of lansoprazole-associated collagenous colitis with longitudinal ulcer[J].J Gastrointest Liver Dis,2013,22(1):9
12 Kawai T,Ashida K,Mizokami Y,et al.Tu1055 TAK-438 versus lansoprazole 15 mg for secondary prevention of peptic ulcers associated with low-dose aspirin therapy:results of a phase 3 trial[J].Gastroenterol,2014,146(5):S739
13 Zhongkai L,Jianxin Y,Weichang C.Vasoactive intestinal peptide promotes gut barrier function against severe acute pancreatitis[J].Mol Biol Rep,2012,39(4):3557-3563
14 J9nsson M,Norrgrd O,Forsgren S.Epithelial expression of vasoactive intestinal peptide in ulcerative colitis:down-regulation in markedly inflamed colon[J].Digest Dis Sci,2012,57(2):303-310
15 Harikrishnan L S,Srivastava N,Kayser L E,et al.Identification and optimization of small molecule antagonists of vasoactive intestinal peptide receptor-1(VIPR1)[J].Bioorganic Med Chem Lett,2012,22(6):2287-2290
2 David,Graham.History of Helicobacter pylori,duodenal ulcer,gastric ulcer and gastric cancer[J].World J Gastroenterol,2014,20(18):5191-5204
3 Ahn JY,Choi CH,Lee JW,et al.The effect of sequential therapy with lansoprazole and ecabet sodium in treating iatrogenic gastric ulcer after endoscopic submucosal dissection:a randomized prospective study[J].JDigestDis,2015,16(2):75-82
4 Martínez C,Ortiz AM,Juarranz Y,et al.Serum levels of vasoactive intestinal peptide as a prognostic marker in early arthritis[J].PLo S One,2014,9(1):e85248
5 郑冬梅.奥美拉唑、泮托拉唑、兰索拉唑治疗胃溃疡疗效比较[J].现代中西医结合杂志,2014,23(22):2461-2463
6 Sreide K,Thorsen K,Sreide J A.Strategies to improve the outcome of emergency surgery for perforated peptic ulcer[J].British J Surg,2014,101(1):e51-e64
7 Mhaskar RS,Ricardo I,Azliyati A,et al.Assessment of risk factors of helicobacter pylori infection and peptic ulcer disease[J].J Global Infectious Dis,2013,5(2):60-67
8 JoséR Martinez Aranzalez,Geraldo E Silveira Alves.Equine gastric ulcer syndrome:risk factors and therapeutic aspects[J].Revista Colombiana De Ciencias Pecuarias,2014,27(3):157-169
9 Gona SK,Alassan MK,Marcellin KG,et al.Postoperative morbidity and mortality of perforated peptic ulcer:retrospective cohort study of risk factors among black Africans in c8te d'ivoire[J].Gastroenterol Res Practice,2016,2016(2):1-7
10 Ahn JY,Choi CH,Lee JW,et al.The effect of sequential therapy with lansoprazole and ecabet sodium in treating iatrogenic gastric ulcer after endoscopic submucosal dissection:a randomized prospective study[J].J Digest Dis,2015,16(2):75-82
11 Kitagawa T,Sato K,Yokouchi Y,et al.A case of lansoprazole-associated collagenous colitis with longitudinal ulcer[J].J Gastrointest Liver Dis,2013,22(1):9
12 Kawai T,Ashida K,Mizokami Y,et al.Tu1055 TAK-438 versus lansoprazole 15 mg for secondary prevention of peptic ulcers associated with low-dose aspirin therapy:results of a phase 3 trial[J].Gastroenterol,2014,146(5):S739
13 Zhongkai L,Jianxin Y,Weichang C.Vasoactive intestinal peptide promotes gut barrier function against severe acute pancreatitis[J].Mol Biol Rep,2012,39(4):3557-3563
14 J9nsson M,Norrgrd O,Forsgren S.Epithelial expression of vasoactive intestinal peptide in ulcerative colitis:down-regulation in markedly inflamed colon[J].Digest Dis Sci,2012,57(2):303-310
15 Harikrishnan L S,Srivastava N,Kayser L E,et al.Identification and optimization of small molecule antagonists of vasoactive intestinal peptide receptor-1(VIPR1)[J].Bioorganic Med Chem Lett,2012,22(6):2287-2290