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(x2=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 120.36pg/ml was set as the cutoff value.The patients with VIP level less than 120.36pg/ml were set into low VIP group (40 cases) and the VIP level more than 120.36pg/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％ (x2 =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.
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