The Preventive Effects of Rabeprazole on Upper Gastrointestinal Tract Hemorrhage in Patients with Severe Acute Pancr eatitis

Background:Severe acute pancreatitis(SAP)is a common critical illness in clinics,and hemorrhage of upper gastro-intestinal tract caused by acute gastric mucosal lesion is a frequent complication of SAP. Aims: To evaluate the effects of rabeprazole on prevention of upper gastrointestinal tract hemorrhage in patients with SAP.Methods:Thirty patients with SAP were randomly divided into two groups:rabeprazole group(n=20),rabeprazole20mg once daily given orally for one week;famotidine group(n=10),famotidine40mg twice daily given intravenously for one week.The bleeding events in the upper gastrointestinal tract and intragastric pH were monitored continuously from24hours before giving the medication till72hours after administration.Results:No hematemesis or melena was observed in rabeprazole group,and one patient had melena in famotidine group,the prevalence rate was10%.After medication,the intragastric pH,and the time percentages of pH3,pH4and pH5were elevated significantly in both groups,the elevation was much higher in rabeprazole group than that in famotidine group(P0.05).No significant side-effect was found in both groups.Conclusions:Both rabeprazole and famotidine can raise the intragastric pH and prevent the upper gastrointestinal tract hemorrhage without causing side-effect in patients with SAP.The intragastric pH raised by rabeprazole is more prolonged than that by famotidine.