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目的 :回顾性分析不同剂量甲氰咪胍对出血性脑卒中 (BCVA )后应激性溃疡出血 (SUH)的影响 ,探讨甲氰咪胍预防BCVA并发SUH的效果和最佳剂量。方法 :13 2 4例病人。甲氰咪胍 (预防Ⅰ )组 5 64例 ,甲氰咪胍 2 0 0mg加0 9%NaCl 10ml静脉推注 ,2次 /d。甲氰咪胍 (预防Ⅱ )组 3 67例 ,甲氰咪胍用量为 80 0mg。不以任何H2 受体拮抗剂预防(对照组 ) 3 93例。比较三组病死率、SUH发生率、发生时间。结果 :SUH总发生率为 4 76%。三组比较以预防Ⅰ组SUH发生率最低 (P <0 0 1) ;预防Ⅱ组与对照组发生率比较无显著性差异。预防Ⅰ组以 1～ 3d预防者SUH的发生率较低(P <0 0 5 ) ;4～ 7d与预防Ⅱ组发生率比较无显著性差异 ,与对照组发生率比较差异显著 (P <0 0 5 ) ;8d以上者发生率与对照组比差异无显著意义。预防Ⅱ组发生率与预防时间三者比较无显著性差异 ,8d以上者与对照组发生率比较无显著性差异。SUH发病时间以预防Ⅰ组较晚 (P <0 0 5 )。以预防Ⅰ组的病死率最低 (P <0 0 5 )。结论 :早期预防性应用小剂量甲氰咪胍可有效地降低BCVA病死率、SUH的发生率、推迟SUH发生时间
Objective: To retrospectively analyze the effect of different concentrations of cimetidine on stress ulcer hemorrhage (SUH) after hemorrhagic stroke (BCVA) and to investigate the effect and optimal dosage of cimetidine in preventing BCVA complicated with SUH. Methods: 132 cases of patients. 5 64 cases of cimetidine (prevention Ⅰ) group, cimetidine 200 mg plus 0.9% NaCl 10 ml intravenous injection, 2 times / d. Cromoguanidine (Prevention Ⅱ) group of 3 67 cases, cimetidine dosage of 80 0mg. Not with any H2 receptor antagonist prevention (control group) 3 93 cases. The mortality of three groups, the incidence of SUH and the time of occurrence were compared. Results: The overall incidence of SUH was 4 76%. The incidence of SUH in group Ⅰ was the lowest among all three groups (P <0.01). There was no significant difference in the incidence of prevention between group Ⅱ and control group. There was no significant difference in the incidence of SUH between prevention group and control group (P <0 05), and the incidence of SUH in prevention group Ⅰ was lower than that of control group (P <0 05) 0 5). There was no significant difference in the incidence of the above 8 days compared with the control group. There was no significant difference in the incidence of prophylaxis group Ⅱ and the prophylactic time among the three groups. There was no significant difference in the incidence of prophylaxis group Ⅱ between the 8th day and the control group. SUH onset time to prevent the late group Ⅰ (P <0 05). To prevent the lowest mortality in group Ⅰ (P <0 05). Conclusion: Early prophylactic use of small doses of cimetidine can effectively reduce the mortality of BCVA, the incidence of SUH, delayed onset of SUH