Clinical effect of omeprazole combined with etamsylate on acute upper gastrointestinal bleeding and immune function

Wang Hui; Ma Yanfang

doi:10.3760/j.issn.1673-4777.2020.04.022

Abstract：Objective To explore the clinical efficacy of omeprazole combined with etamsylate in treatment of acute upper gastrointestinal bleeding and the effect on immune function. Methods From February 2017 to February 2018, 120 patients with acute upper gastrointestinal bleeding who were treated by Beijing Ditan Hospital, Capital Medical University were randomly assigned to etamsylate injection(n=60) and omeprazole plus etamsylate injection( n=60 ) . Hemostasis effect, blood pressure fluctuation and abdominal pain relief time were observed. H+-K+-ATPase activity, fibrin stabilizing factor(FSF), fibrinogen(FIB), platelet function and T lymphocyte subsets were detected. Clinical therapeutic effect and incidence of adverse reactions were analyzed. Results Omeprazole combined with etamsylate showed faster effects on hemostasis, blood pressure stabilization and abdominal pain relief than etamsylate alone[(1. 13 ± 0. 22)d vs (1. 61 ± 0. 29)d, (6. 7 ± 2. 0)d vs (9. 9 ± 2. 0)d, (1. 3 ± 0. 3)d vs (2.6±0.4)d](all P <0.001). After treatment, activity of H+-K+-ATPase with omeprazole plus etamsylate treatment was lower and levels of FSF, FIB, platelet count, average platelet volume, platelet distribution width and platelet aggregation rate were higher than those with etamsylate(all P<0. 05). After treatment, levels of CD3+ and CD4+ with omeprazole plus etamsylate treatment were higher and CD8+ level was lower than with etamsylate( all P<0. 05). Total effective rate of omeprazole combined with etamsylate was significantly higher than that of etamsylate [96.7％(58/60) vs 83. 3％(50/60)] (P =0. 015). Incidence of adverse reactions showed no significant difference(P=0.343). Conclusion Omeprazole combined with etamsylate treating acute upper gastrointestinal hemorrhage can effectively inhibit H+-K+-ATPase activity, activate FSF and FIB, and improve coagulation, platelet function and immune function.