2021 年第 7 期 第 16 卷

酚磺乙胺联合质子泵抑制剂奥美拉唑治疗急性上消化道出血的效果及对患者免疫功能的影响

The therapeutic effect of etamsylate combined with proton pump inhibitor omeprazole on patients with acute upper gastrointestinal hemorrhage and its influence on immune function

作者：吴伟1叶晓丹2刘剑烽1曾凤兰1赖伟华1戴穗茹1

英文作者：Wu Wei1 Ye Xiaodan2 Liu Jianfeng1 Zeng Fenglan1 Lai Weihua1 Dai Suiru1

单位：1广州市红十字会医院暨南大学附属广州红十字会医院急诊科510220；2广东省汕头市中心医院内镜中心515000

英文单位：1Department of Emergency Guangzhou Red Cross Hospital the Affiliated Hospital Jinan University Guangzhou 510220 China; 2Endoscopy Center Shantou Central Hospital Guangdong Province Shantou 515000 China

关键词：急性上消化道出血；酚磺乙胺；质子泵抑制剂；奥美拉唑；免疫功能

英文关键词：Acuteuppergastrointestinalhemorrhage;Etamsylate;Protonpumpinhibitor;Omeprazole;Immunefunction

• 摘要：

• 目的 探讨酚磺乙胺联合质子泵抑制剂奥美拉唑治疗急性上消化道出血的效果及对患者免疫功能的影响。方法 选取2017年4月至2018年4月广州市红十字会医院收治的急性上消化道出血患者88例，按照随机数字表法分为对照组和联合组，各44例。对照组在常规治疗基础上给予质子泵抑制剂奥美拉唑治疗，联合组在对照组基础上给予酚磺乙胺治疗。比较2组治疗前后免疫功能、凝血功能指标及止血效果，比较2组治疗总有效率和不良反应发生情况。结果 2组治疗后CD+4、CD+8、CD+4/CD+8比值水平均明显高于治疗前，且联合组明显高于对照组（均P＜0.05）；纤维蛋白原水平高于治疗前，且联合组高于对照组（均P＜0.05）；D-二聚体水平、活化部分凝血活酶时间、凝血酶原时间、凝血酶时间均低于/短于治疗前，且联合组低于对照组（均P＜0.05）。联合组稳定血压需要时间、止血需要时间、住院时间均短于对照组［（4.0±1.4）h比（9.2±2.1）h、（1.30±0.24）d比（1.89±0.45）d、（6.5±1.2）d比（13.2±4.1）d］，胃管引流量少于对照组［（210±34）ml比（319±52）ml］，差异均有统计学意义（均P＜0.05）。联合组治疗总有效率高于对照组［90.9%(40/44)比72.7%(32/44)］，差异有统计学意义（P=0.027）。2组不良反应发生率比较，差异无统计学意义（P=0.179）。结论 酚磺乙胺联合质子泵抑制剂奥美拉唑对急性上消化道出血患者止血效果显著，能提高患者免疫功能，改善患者凝血功能。

• Objective To investigate the therapeutic effect of etamsylate combined with proton pump inhibitor omeprazole on patients with acute upper gastrointestinal hemorrhage and its influence on immune function. Methods From April 2017 to April 2018, 88 patients with acute upper gastrointestinal hemorrhage in Guangzhou Red Cross Hospital were selected and randomly divided into the control group and the combined group, with 44 cases in each group. The control group was treated with proton pump inhibitor omeprazole on the basis of basic treatment, and the combined group was treated with etamsylate on the basis of the control group. The immune function, coagulation function indexes and hemostatic effect were compared between the two groups before and after treatment. The total effective rate and adverse reactions were compared between the two groups. Results After treatment, the levels of CD+4, CD+8, CD+4/CD+8 ratio in the two groups were significantly higher than those before treatment, and those in the combined group were significantly higher than those in the control group (all P＜0.05). After treatment, the levels of fibrinogen in the two groups were higher than those before treatment, and that in the combined group was higher than that in the control group; the levels of D-dimer, activated partial thromboplastin time, prothrombin time and thrombin time in the two groups were lower/shorter than those before treatment, and those in the combined group were lower/shorter than those in the control group(all P＜0.05). The blood pressure stabilization time, hemostasis time and length of stay in the combined group were shorter than those in the control group［（4.0±1.4）h vs （9.2±2.1）h, （1.30±0.24）d vs （1.89±0.45）d, （6.5±1.2）d vs （13.2±4.1）d］, and the gastric tube drainage volume in the combined group was less than that in the control group［（210±34）ml vs （319±52）ml］(all P＜0.05). The total effective rate in the combined group was higher than that in the control group［90.9%(40/44) vs 72.7%(32/44)］(P=0.027). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.179). Conclusion Etamsylate combined with proton pump inhibitor omeprazole has significant hemostatic effect on patients with acute upper gastrointestinal hemorrhage, which can improve the immune function and coagulation function of patients.