Analysis of the effectiveness and effect-cost of different proton pump inhibitors (PPI) in the treatment of peptic ulcer bleeding

Abstract

目的對不同質子泵抑制劑對消化性潰瘍出血的療效及療效-費用分析進行分析。方法83例消化性潰瘍出血病人隨機分為4組,分別給予:①靜脈注射奧美拉唑40mg,q12h;②靜脈注射奧美拉唑40mg,q12h,聯合睡前一次靜脈注射法莫替丁20mg;③靜脈注射泮妥拉唑40mg,q12h;④靜脈注射泮妥拉唑40mg,q12h,聯合睡前一次靜脈注射法莫替丁20mg。療程均為5d。記錄患者的止血時間、輸血量、住院時間、轉診手術率、死亡率及住院總費用。結果4組患者的止血時間分別為1.3±1.0d、1.2±0.8d、1.3±0.8d、1.4±0.8d(P>0.05);輸血量分別為1.7±2.8U、1.5±2.5U、1.6±2.4U、1.6±2.5U(P>0.05);再出血率為5.3%(1/19)、0、0、0(P>0.05);手術率和死亡率均為0;住院時間分別為10.6±7.4d、11.7±6.9d、12.9±5.9d、11.6±7.5d(P>0.05);住院總費用分別為7337.2±2133.1元、6908.6±2466.3元、7266.9±2993.1元、6646.3±2544.3元(P>0.05)。結論靜脈注射奧美拉唑和泮妥拉唑均能有效治療消化性潰瘍出血,療效及住院費用相當,夜間無需加用H2受體拮抗劑亦能達到同樣療效。 Objective The aim of this study was to investigate the effectiveness and effect-cost in the treatment of patients with peptic ulcer bleeding by using proton pump inhibitor (PPI) omeprazole or pantoprazole. Methods Eighty-three patients with peptic ulcer bleeding were randomly divided into 4 groups. Patients in group A (19 cases) were treated by intravenous injection of 40 mg omeprazole (q12h for 5 days); Patients in group B (22 cases) received intravenous injection of 40 mg omeprazole (q12h), followed by the intravenous injection of 20 mg H2 receptor antagonist (H2RA) famotidine before sleep for five days. In group C (22 cases), the patients were given intravenous injection of 40 mg pantoprazole (q12h for 5 days); while in group D (20 cases), following intravenous injection 40 mg pantoprazole (q12h), the patients were treated by intravenous injection of 20 mg famotidine before sleep for 5 days. The haemorrhage time, rehaemorrhagia rate, operability and mortality rate, blood transfusion unit, hospital stay and cost were compared among four groups. Results The average time needed for hemostasis were 1.3 ± 1.0, 1.2 ± 0.8, 1.3 ± 0.8, 1.4 ± 0.8 days in group A, B, C and D, respectively. The rehaemorrhagia rate in group A was 5.3%, and was null in other three groups. Both the operability and the mortality rates of 4 groups were null. The blood transfusion units in group A, B, C and D were 1.7 ± 2.8, 1.5 ± 2.5, 1.6 ± 2.4 and 1.6 ± 2.5 U, respectively. The average time in ward in groups A, B, C and D were 10.6 ± 7.4, 11.7 ± 6.9, 12.9 ± 5.9, 11.6 ± 7.5 days; and the average costs were 7,337.2 ± 2,133.1, 6,908.6 ± 2,466.3, 7,266.9 ± 2,993.1 and 6,646.3 ± 2,544.3 RMB, respectively. No significant difference was found in all the parameters among the four groups. Conclusion The effectiveness of intravenous injection of omeprazole or pantoprazole twice daily on treatment of peptic ulcer bleeding is similar.