Effect of repeated injection and continuous infusion of omeprazole and ranitidine on intragastric pH over 72 hoursFigure 1
Effect of repeated injection and continuous infusion of omeprazole and ranitidine on intragastric pH over 72 hoursFigure 1
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奥美拉唑和雷尼替丁72小时内重复注射和持续滴注对胃内pH值的影响图1
DOI：
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发表时间：
1999
影响因子：
9.8
通讯作者：
W. Inauen
中科院分区：
文献类型：
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作者：
P. Netzer;C. Gaia;M. Sandoz;T. Huluk;A. Gut;F. Halter;J. Hüsler;W. Inauen
目的：在健康受试者和出血性消化性溃疡患者中，静脉给予雷尼替丁和奥美拉唑在治疗第一天达到高胃内pH值。然而，关于24小时后的抗分泌作用的数据很少。此外，输注或注射奥美拉唑的优越性仍未得到证实。因此，我们比较了高剂量奥美拉唑和雷尼替丁输注和注射在关键的头72小时内的抗分泌作用。方法：共有34名健康志愿者随机分为双盲交叉72小时胃内pH测定研究（数据比较：pH中位数，pH >4和pH >6的时间百分比）。奥美拉唑输注：初始剂量80 mg + 8 mg/h；奥美拉唑注射液：初始剂量80 mg + 40 mg/6 h；雷尼替丁输注：初始剂量50mg + 0.25 mg/kg/h；结果：输注奥美拉唑与输注雷尼替丁：第1天：pH中位数为6.1 vs 5.1 (p= 0.01)， 95%vs 70% pH为>.4 (p < 0.01)；第2天：pH中位数6.2 vs 3.2 (p < 0.01)；pH值为100%vs 38% (p < 0.01)；第3天：pH中位数为6.3 vs 2.7 (p < 0.01)；pH为100%vs 26% （p < 0.01）。两种药物的注射效果均明显低于第1天的输注效果。此后，注射奥美拉唑与输注奥美拉唑几乎相同，而注射雷尼替丁与输注效果相同。结论：我们的研究首次表明，输注奥美拉唑显著优于所有其他方案，每天的中位pH值为bb0.6。然而，雷尼替丁的耐受性作用导致抗分泌活性在第2天和第3天迅速丧失，使得它不适合在高胃内ph水平似乎是必需的情况下使用。
Objective:In healthy subjects and patients with bleeding peptic ulcers, ranitidine and omeprazole, given parenterally, achieve high intragastric pH values on the first day of therapy. However, data on the antisecretory effect beyond the first 24 h is scanty. In addition, the superiority of either infusion or injection of omeprazole remains unproven. Thus, we have compared the antisecretory effect of high dose omeprazole and ranitidine infusion and injection over the critical first 72 h.Methods:A total of 34 healthy volunteers were randomized into a double-blind crossover 72 h intragastric pH-metry study (data compared: median pH, percentage of time with pH >4 and pH >6). Omeprazole-infusion: initial bolus of 80 mg + 8 mg/h; omeprazole-injection: initial bolus of 80 mg + 40 mg/6 h; Ranitidine-infusion: initial bolus of 50 mg + 0.25 mg/kg/h; ranitidine-injection: 100 mg/6 h.Results:Omeprazole-infusion versus ranitidine-infusion: on day 1: median pH 6.1 vs 5.1 (p= 0.01) and 95%vs 70% was pH >4 (p < 0.01); on day 2: median pH 6.2 vs 3.2 (p < 0.01); and 100%vs 38% was pH >4 (p < 0.01); on day 3: median pH 6.3 vs 2.7 (p < 0.01); 100%vs 26% was pH >4 (p < 0.01). Injections of both drugs were significantly less effective than the infusions on day 1. Thereafter, omeprazole injection was almost as effective as omeprazole infusion, whereas ranitidine injection and infusion were equally effective.Conclusion:Our study shows, for the first time, that omeprazole infusion was significantly superior to all other regimens by having a high median pH >6 on each day. The tolerance effect of ranitidine, however, led to a rapid loss of antisecretory activity on days 2 and 3, rendering it inappropriate for situations in which high intragastric pH-levels appear to be essential.