奥曲肽注射液治疗食管胃底静脉曲张破裂出血的有效性和安全性

20068274JournalofCapitalUniversityofMedicalSciencesAug.2006Vol.27No.43(,)131,68,;63,()2,011mg,016mg5%500mL,42mL/h(50g/h),1/12h24h,4d;,;;2(P0105),61224h2(P0105),;;;R575.2+1EfficacyandSafetyOctreotideintheTreatmentofAcuteVaricealBleedinginCirrhoticPatientsYangXun,LiHongmei,YuZhonglin,ZhangShutian3(DepartmentofDigestiveDisease,BeijingFriendshipHospital,CapitalUniversityofMedicalSciences,BeijingDigestiveDiseaseCenter)ABSTRACTObjectiveToinvestigatetheefficacyandsafetyofoctreotideacetateandsandostatinincontrollingesophagealvaricealbleeding,andmakecomparisonbetweendomasticandimportedproducts.MethodsOnehundredandthirty2onecirrhoticpatientswithesophagealandgastricvaricealbleedingweredividedintotwogroupsrandomly.68casesinGroupAweretreatedwithoctreotideacetateinfusion.63casesinGroupBweretreatedwithsandostatininfusion.GroupAreceivedoctreotideacetateinfusionof50g/hintravenouslyfor120hafterabolusof100g.GroupBsamedosesandostatininsameway.Thebloodpressure,arterialpulseandbloodtransfusionvolumeweremonitoredandrecordedinthecourseoftheinvestigation.ResultsThebase2linedatainthetwogroupsweresimilar.Theefficacyofoctreotideinhemostasis,thebloodtransfusionvolumeandmortalityhavenosignificantdifferencebetweentwogroupsinstatistically(P0105).ConclusionBothoctreotideandsandostatinpresentahighinitialandfinalcontrolofesophagealandgastricvaricealbleeding.Keywordsoctreotide;esophagealandgastricvarices;bleeding;therapy3(Correspondingauthor),1988,(),11.1:1),;2)1870,;3)48h,();4)1h,;5)24h:;,,,6),(3cm),,:1),7d(27)H2,,(TIPS);2);3)();4);5);6);7);8):1);2),;3);4);5)24h;6),;7)1.2,,011mg/,,011mg/1.3144,72,7,2(P0105)1.4:011mg,5min,016mg5%500mL,42mL/h(50g/h),1/12h24h,4d:,1.51)()H2(K1)2),,48h,3)1.61)123612243648h2)1236122436487296120h(),122436487296120h3)120h1.7:1)::;;2):24h3):,:::1.8,1(intentiontotreat,ITT)CRF,(perprotocol,PP)22.1142ITT,271;13124h,PP,6863;119120h,60592.2:24h:69101%66120%(ITT),69112%65108%(PP),(Log2rank),2(P0105,1)::9138%14129%(ITT),9168%10191%(PP),2(P0105)8544:12Tab1Therateofstanchindifferenttime%t/hITTPPOctreotide(n=71)Sandostatin(n=71)Octreotide(n=68)Sandostatin(n=63)322.5414.0822.0615.87629.5823.9429.4125.401243.6636.6244.1236.512469.0166.2069.1265.083678.8778.8779.4177.784890.1488.7391.1887.302.3:(180114266152)mL(249104392126)mL(ITT),(183105270128)mL(234129387182)mL(PP),2(P0105)2.49186%4123%;,4123%,2,1,;2182%,2,2(P0105)2,,3,,,,,,:1),,,,;2),;3),,,;4),,,[1]Meta,[2],Villanueva[3],,,,24h:69112%65108%(PP),2(P0105)::9168%10191%(PP),2(P0105),ITTPPBildozola[4](39)(37),8416%9416%,(P0105)[5],:;;;;;4[1]JenkinSA,BereinA.Therelativeeffectivenessofsomatostatinandoctreotidetherapyinpancreaticdisease[J].AlimentPharmacolTher,1995,9:349.[2]ComarKM,SanyalAJ.Portalhypertensivebleeding[J].GastroenterolClinNorthAm,2003,32:10791105.[3]VillanuevaC,OrtizJ,MinanaJ,etal.Somatostatintreatmentandriskstratificationbycontinuousportalpressuremonitoringduringacutevaricealbleeding[J].Gastroenterology,2001,121:110117.[4]BildozolaM,KravetzD,ArgonzT,etal.Efficacyofoctreotideandsclerotherapyinthetreatmentofacutevaricealbleedingincirrhoticpatients.Aprospective,multicentric,andrandomizedclinicaltrial[J].ScandJGastroenterology,2000,35:419425.[5].[J].,2005,25:49(:20060616)954