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目的 本研究以胃癌根治术后病人为对象，在限制非蛋白热卡和氮源的条件下，观察雷尼替丁对术后应激反应和蛋白质代谢的影响。 方法 将３０ 例因胃癌行根治术的病人，随机分为雷尼替丁组（ｎ＝１５）和对照组（ｎ＝１５） 两组，雷尼替丁组给予雷尼替丁１００ ｍｇｉｍ ｑ１２ｈ；对照组不使用雷尼替丁或西咪替丁等类似药物。两组病人均于术后第１ 日晨开始自周围静脉给予低热卡静脉营养支持３ 天（ 非蛋白热卡：７５－６ ｋＪ·ｋｇ－１·ｄ－１；氮量：０－０８ ｇ·ｋｇ－ １·ｄ－ １） ，并监测体温、肝功能、白／球蛋白、血糖、皮质醇、尿儿茶酚胺及香草基苦杏仁酸的水平和氮平衡变化。 结果 两组相比，雷尼替丁组每日负氮平衡现象均明显改善，其中术后第１ 天与术后第３ 天有显著性差异，术后３ 天的累积氮平衡差别显著（ －２２±１０ ｖｓ． －３７±１６ ｇ，Ｐ＜ ０－０５） ；连续应用雷尼替丁３ 天，血皮质醇浓度显著降低（１７ ±５ ｖｓ．２４±９ μｇ／Ｌ，Ｐ＜０－０５）；两组病人体温、肝功能、白／球蛋白、血糖、尿儿茶酚胺及香草基苦杏仁酸变化无明显差异。 结论 在低热卡静脉营养支持下，雷尼替丁对因胃癌行根治术病人术后可改善负氮平衡现象；连续应用３ 天可显著降低血皮质
Objective To investigate the effects of ranitidine on stress response and protein metabolism after radical gastrectomy in patients with gastric cancer under the condition of limiting non-protein calorie and nitrogen sources. Methods Thirty patients undergoing radical gastrectomy were randomly divided into ranitidine group (n=15) and control group (n=15). The ranitidine group was given ranitidine 100 mg q12h; The control group did not use similar drugs such as ranitidine or cimetidine. Both groups of patients began to receive low-calorie calorie nutritional support from the peripheral vein for 3 days on the morning of the first postoperative day (non-protein calorie card: 75-6 kJ·kg-1·d-1; nitrogen: 0-08 g· Kg-1 ·d- 1), and monitor body temperature, liver function, white/globulin, blood glucose, cortisol, urinary catecholamines, and vanillyl-mandelic acid levels and nitrogen balance changes. Results Compared with the two groups, the daily negative nitrogen balance in the ranitidine group was significantly improved. There was a significant difference between the first postoperative day and the third postoperative day. The cumulative nitrogen balance at the 3rd postoperative day was significantly different (- 22±10 vs. -37±16 g, P< 0-05); Serum concentration of cortisol was significantly decreased after 3 consecutive days of ranitidine (17 ±5 vs.24±9 μg/L, P<0- 05); There were no significant differences in changes in body temperature, liver function, white/globin, blood glucose, urinary catecholamines, and vanillyl mandelic acid between the two groups. Conclusion Ranitidine can improve negative nitrogen balance after radical resection for patients with gastric cancer with low calorie nutrition support; continuous application for 3 days can significantly reduce the blood cortex