兰索拉唑对脑外伤并发应激性溃疡患者血清SOD、GAS和血浆胃动素的影响

摘要

目的 探索兰索拉唑在脑外伤并发应激性溃疡患者中对患者血清超氧化物歧化酶(SOD)、胃泌素(GAS)以及血浆胃动素(MTL)水平的影响.方法 将2011年6月至2016年5月昆明医学院附属第二医院收治的78例颅脑外伤合并应激性溃疡患者以数字表法随机分为观察组和对照组,每组39例,所有患者入院后符合手术指征者积极给予手术治疗,无手术指征患者则积极给予脱水、降低颅内压、营养神经、抗感染、纠正水电解质平衡紊乱以及营养支持等保守治疗.观察组在上述治疗基础上给予兰索拉唑治疗,对照组在上述治疗基础上给予奥美拉唑治疗,疗程均为7 d,比较两组患者治疗前后的血清SOD、GAS、MTL水平以及颅内压力(IPC)和格拉斯哥评分(GCS)的变化.结果 观察组患者的治疗总有效率为84.6％,略高于对照组的76.9％,但差异无统计学意义(P>0.05);治疗前两组患者的血清SOD、Nu/mL、GAS及血浆MTL水平比较差异均无统计学意义(P>0.05);治疗后,观察组和对照组患者的SOD[(89.3±14.4)Nu/mL vs(76.4±14.6)Nu/mL]均显著增高,GAS[(81.4±15.6)ng/L vs(86.6±16.2)ng/L]和MTL[(142.3±32.6)ng/L vs(167.6±33.1)ng/L]均显著降低,且治疗后观察组SOD显著高于对照组、GAS与MTL均显著低于对照组,差异均有统计学意义(P<0.05);治疗前,观察组和对照组患者的IPC[(32.4±3.8)mmHg vs(32.6±3.9)mmHg]、GCS[(4.5±2.1)分vs(4.6±2.3)分]比较差异均无统计学意义(P>0.05),治疗后,观察组和对照组患者IPC分别为(16.6±3.5)mmHg和(24.4±3.7)mmHg,GCS分别为(9.1±2.3)分和(5.8±2.2)分,差异具有统计学意义(P<0.05),且治疗后观察组IPC低于对照组、GCS高于对照组,差异均具有统计学意义(P<0.05).结论 兰索拉唑对颅脑外伤合并应激性溃疡患者具有良好疗效,其能够更好地提高SOD并降低GAS、MTL水平,利于颅脑外伤病情的好转.%Objective To discuss the influence of lansoprazole on serum superoxide dismutase (SOD), gastrin (GAS), and plasma motilin (MTL) in patients with brain injury complicated with stress ulcer. Methods A total of 78 pa-tients with brain injury complicated with stress ulcer, who admitted to the Second Affiliated Hospital of Kunming Medi-cal University from June 2011 to May 2016, were selected and randomly divided into the observation group (n=39) and the control group (n=39). The patients met the indication of operation were given surgical treatment, and the patients without operation indications were given dehydration, intracranial pressure reduction, neurotrophic therapy, anti-infec-tion, correction of water and electrolyte balance disorders, nutritional support and other conservative treatment. The ob-servation group was treated with lansoprazole based on the above treatment, and the control group were treated with omeprazole based on the above treatment. Then the clinical effects, levels of serum SOD, GAS, plasma MTL were con-trasted between the two groups after 7 days. Results The total effective rate in the observation group was 84.6％, which was a little higher than 76.9％in the control group (P>0.05). Before the treatment, there was no significant differ-ence in the level of serum SOD, GAS, plasma MTL (P>0.05). After the treatment, SOD in the two groups were signifi-cantly increased, and SOD in the observation group was (89.3±14.4) Nu/mL, which was significantly higher than (76.4± 14.6) Nu/mL in the control group (P<0.05);GAS and MTL in the two groups were significantly decreased, and GAS and MTL in the observation group were (81.4±15.6) ng/L and (142.3±32.6) ng/L, which were significantly lower than (86.6 ± 16.2) ng/L and (167.6 ± 33.1) ng/L in the control group (P<0.05); there was no significant difference in IPC (32.4±3.8) mmHg vs (32.6±3.9) mmHg and GCS (4.5±2.1) vs (4.6±2.3) before the treatment between the two groups (P>0.05); after the treatment, IPC in the observation group was (16.6 ± 3.5) mmHg, which was significantly lower than (24.4 ± 3.7) mmHg in the control group (P<0.05). GCS in the observation group was (9.1 ± 2.3), which was significantly higher than (5.8±2.2) in the control group (P<0.05). Conclusion Lansoprazole has the good curative effects in the pa-tients with brain injury complicated with stress ulcer, which can effectively improve SOD and reduce GAS and MTL lev-els, and is beneficial to the improvement of craniocerebral trauma.