[ABSTRACT]Objective:Through the combination with hemocoagulase and pantoprazole on gastrointestinal bleeding,to observe the changes of serum BUN,LPO,NO,TNF-,hs-CRP alpha and cortisol levels,explore the mechanism of combina-tion.Methods:A total of 1 10 cases of upper gastrointestinal bleeding in our hospital were selected and divided into the control group and the observation group,55 cases for each group.Patients were Treated with bed rest,fasting,intravenous nutrition, oxygen,and according to the individual situation actively supplement blood capacity,and the control group were treated with 40 mg intravenous pantoprazole treatment,2 times 1 day;the patients in the observation group were treated with 2KU hemo-coagulase injection based on the treatment of control group,2 times of intravenous injection per day,and all patients were trea-ted for 3 days,and then the BUN (blood urea nitrogen),LPO (LPO),NO (nitric oxide),TNF-α(TNF alpha),hs-CRP (high sensitivity C reactive protein)and cortisol (cortisol)were detected.Results:(1)There were no significantly differences of the serum levels of BUN、LPO、NO of the two groups before treatment (P > 0.05 ).After treatment,the serum levels the two groups were significantly lower than before treatment,and LPO,BUN,NO levels in the observation group were significantly better than the control group ,the difference was significant (P <0.05);(2)There were no significantly differences of the ser-um levels of TNF-α、hs-CRP、cortisol of the two groups before treatment (P >0.05).After treatment,the serum levels the two groups were significantly lower than before treatment,and TNF-α、hs-CRP、cortisol levels in the observation group were signifi-cantly better than the control group ,the difference was significant (P <0.05 ).Conclusion:The treatment of patients with combined use of hemocoagulase and pantoprazole on gastrointestinal bleeding,can significantly improve the serum levels of BUN,LPO,NO,TNF-,hs-CRP and alpha cortisol levels,and further illustrates the synergistic effect of the combination,al-so shows that the combination of two drugs for patients with upper gastrointestinal bleeding can be improve the symptoms of hemorrhage,reduce inflammation and stress,improving the treatment effect.%目的：：通过对上消化道出血患者联合应用白眉蛇毒血凝酶和泮托拉唑,观察患者血清 BUN、LPO、NO、TNF-α、hs-CRP 及皮质醇水平的变化,探讨联合用药的作用机制.方法：回顾性选取110例于我院进行诊治的上消化道出血患者,分为对照组和观察组,每组55例.所有患者根据个体情况积极补充血容量,对照组给予40 mg 泮托拉唑静脉滴注治疗,1天2次；观察组在对照组治疗的基础上加用2KU 白眉蛇毒血凝酶静脉注射治疗,1天分2次静注,所有患者均连续治疗3天.并于治疗前后早晨空腹抽取静脉血,然后对 BUN、LPO、NO、TNF-α、hs-CRP 以及皮质醇进行检测.结果：(1)治疗前,两组血清 BUN、LPO、NO 水平之间相比,差异无显著性(P ＞0．05)；治疗后,两组血清 BUN、LPO、NO 水平均明显改善,与同组治疗前相比,差异均具有显著性(P ＜0．05),且观察组血清 BUN、LPO、NO 水平改善程度明显优于对照组,差异均具有显著性(P ＜0．05).(2)治疗前,两组血清 TNF-α、hs-CRP、cortisol水平之间相比,差异无显著性(P ＞0．05)；治疗后,两组血清 TNF-α、hs-CRP、cortisol 水平均明显改善,与同组治疗前相比,差异均具有显著性(P ＜0．05),且观察组血清 TNF-α、hs-CRP、cortisol 水平改善程度明显优于对照组,差异均具有显著性(P ＜0．05).结论：对上消化道出血患者联合应用白眉蛇毒血凝酶和泮托拉唑进行治疗,可以明显改善患者血清 BUN、LPO、NO、TNF-α、hs-CRP 及 cortisol 水平,且进一步说明了联合用药的协同增效作用,也说明两药合用对于上消化道出血患者可以明显改善出血症状,降低机体炎症反应和应激过程,进一步提高治疗效果.
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