埃索美拉唑干预胃食管反流患者夜间酸突破的临床研究  

Efficacy of esomeprazole against nocturnal acid breakthrough in patients with gastroesophageal reflux

作　　者：董雪梅[1] 夏时海[2] 周秀[1] 曹占良[1] 

机构地区：[1]武警医学院附属医院检验科,天津300162 [2]武警医学院附属医院消化内科,天津300162

出　　处：《武警医学》2006年第5期351-353,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨埃索美拉唑干预胃食管反流病患者(GERD)的夜间酸突破(NAB)现象及其与幽门螺杆菌(Hp)感染之间的关系。方法GERD患者随机分为5组,每组10例,分别接受:A组:口服埃索美拉唑40 mg,1/d;B组:口服埃索美拉唑40 mg,2/d;C组:口服埃索美拉唑40 mg,早1次,口服高舒达20 mg,晚1次;D组:口服埃索美拉唑40 mg,2/d,睡前口服高舒达20 mg,1次;E组:口服高舒达20 mg,2/d。均用药7 d并于第7天早上8时起连续24 h监测其胃内pH值。结果5组患者的平均胃内pH值、平均中位pH值、夜间平均胃内pH值和夜间平均中位pH值均有不同程度升高,B、C、D组升高明显,显著高于A、E组(P<0.05);A、E组夜间pH<4.0的时间占夜间监测时间的百分比显著高于B、C、D组(P<0.05);埃索美拉唑2次用药组仅有1例NAB发生(2.0%),显著低于1次用药组(P<0.05)。结论GERD患者NAB的发生与埃索美拉唑剂量、用药方法、是否加用高舒达及Hp感染相关。Objective To assess the effect of esomeprazole on nocturnal acid breakthrough（NAB） and its relationship with Helirobacter pylori infection in patients with gastroesophageal reflux （GER）. Methods Fifty GER patients were randomly allocated into five groups. The patients were treated with esomeprazole 40 mg once daily orally （group A）, twice daily（group B） ,esomeprazole 40 mg once a.m. and famofidine 20 mg once p.m. daily （group C）, esomeprazole 40 mg twice and famofidine 20 mg once q.n. daily （group D）, and famotidine 20 mg twice daily （group E） all for 7 days. Intragastric pH over 24 hours was consecutively recorded on the eighth day for each patient. Results High intragastric pH was produced in all five groups. The mean intragastric pH, median intragastric pH, nocturnal mean pH and nocturnal median pH in groups B,C, D were significantly higher than those of groups A, E. NAB occurred in only 1 patient in esomeprazole twice daily groups （groups B and D）, with an incidence （200%） significantly lower than those in other groups A, C, E（26.0%, P 〈 0.05）. The incidence of NAB in H. pylori negative patients （47.8 % ） was significantly higher than that in H. pylori positive（ 11.1% ） patients（ P 〈 0.05）. Conclusions Dosage and administration of esomeprazole, famotidine, and H. pylori infection are closely related to the incidence of NAB.

关 键 词：胃食管反流病 夜间酸突破 埃索美拉唑 高舒达 

分 类 号：R975[医药卫生—药品] R573.1[医药卫生—药学]