Nocturnal acid breakthrough in post-stroke stress ulceration

Objective To observe nocturnal acid breakthrough (NAB) in post-stroke stress ulcer (SU),and to explore the effects of various therapeutic regimens on NAB control and patient mortality.Methods 100 patients with acute stroke,who were admitted to Shaoxing People's Hospital during October 2007 to October 2009,were randomly allocated into three groups.Group A received intravenous injection of 40 mg Omeprazole twice daily,Group B received 40 mg Omeprazole once daily by oral use or through gastric tube,and Group C received intravenous injection of 40 mg Omeprazole (twice daily) plus 600 mg Cimetidine qN.24-hour intragastric pH test was performed on the sixth day.Results (1)NAB in group C was significantly lower than that in groups A and B (P0.01),and that in group B was significantly higher than groups A and C (P0.01);(2)Groups C and B had greater values of mean intragastric pH,median intragastric pH,nocturnal mean pH,noctrunal median pH,and longer time with pH below 4.0 during 24-hour and at night,than group B (P0.01,P0.05).(3)The incidence and mortality of stress ulceration:those in group C were lower than groups A and B,and those in group A were lower than group B (P0.05).Conclusion The incidence of NAB may be reduced by more frequenct use and higher dose of omeprazole,or by combining with Cimetidine,when can benefit prevention of SU and prognosis of stroke patients.