摘要目的 观察奥美拉唑联合复方倍他米松治疗上消化道出血合并痛风急性发作的疗效.方法 收集2014年2月至2016年2月本院消化内科住院治疗的上消化道出血合并痛风急性发作患者40例,按随机数字法分为观察组(n=20)与对照组(n=20).两组患者均给予奥美拉唑40 mg静脉滴注,每日2次.对照组给予扶他林软膏外敷患处,每日2次;观察组给予复方倍他米松1 ml肌肉深部注射1次,疗程均为1周.治疗1周后进行两组患者的疗效评价.治疗前、治疗1周后检测两组患者血红蛋白(Hb)水平及相关血生化指标,包括血尿素氮(BUN)、肌酐(Scr)和尿酸(BUA).记录两组患者的输血量和治疗相关不良反应发生情况.结果 疗效评价显示,治疗1周后观察组和对照组的总有效率分别为95.0％(19/20)、70.0％(14/20),组间比较差异有统计学意义(P<0.05).与治疗前比较,治疗1周后两组患者血BUN、BUA均显著下降(均P<0.05).治疗前、治疗1周后,两组患者血BUN、Scr、BUA组间比较,差异均无统计学意义(均P>0.05).两组患者输血量组间比较差异无统计学意义(P>0.05).与治疗前比较,治疗1周后两组患者Hb水平均显著升高(均P<0.05).治疗前、治疗1周后两组患者Hb水平组间比较,差异均无统计学意义(均P>0.05).两组患者治疗期间未发生明显不良反应.结论 奥美拉唑联合复方倍他米松治疗上消化道出血合并痛风急性发作的疗效较好.

abstractsObjective To investigate the efficacy of omeprazole combined with compound betamethasone in the treatment of upper gastrointestinal bleeding complicated with acute gout. Methods Forty patients with upper gastrointestinal bleeding complicated with acute gout hospitalized in our Department of Gastroenterology between February 2014 and February 2016 were included,and were divided into the study group(n=20)and the control group(n=20)by the random table method. The two groups of patients were given intravenous omeprazole 40 mg,twice daily. In addition,the control received topical application of Votalin ointment,twice daily;the study group received 1 ml compound betamethasone via deep muscular injection. The treatment course lasted one week. The efficacy in the two groups was evaluated after one week of treatment. The levels of hemoglobin (Hb) and blood biochemical parameters including blood urea nitrogen (BUN),serum creatinine (Scr) and blood uric acid (BUA),were measured before treatment and at one week after treatment. The blood transfusion and treatment-related adverse events were recorded in both groups. Results After one week of treatment,the overall effective rates in the study group and the control group were 95.0％(19/20)and 70.0％(14/20),respectively,with statistically significant difference(P<0.05). Compared with baseline,the BUN and BUA levels in the two groups were significantly reduced after one week of treatment(both P<0.05). There were no significant differences in BUN,Scr and BUA between the two groups before and at one week after treatment(all P>0.05). There was no significant difference in blood transfusion between the two groups (P>0.05). The levels of Hb were significantly increased in both groups compared with baseline(both P<0.05). There was no significant difference in Hb level between the two groups before and at one week after treatment (both P>0.05). There were no significant adverse events during the treatement in the two groups of patients. Conclusion Omeprazole combined with compound betamethasone may be more effective for the treatment of upper gastrointestinal bleeding complicated with acute gout.