胃食管反流患者夜间酸突破与食管酸暴露及幽门螺杆菌感染的临床研究  

Study on nocturnal acid breakthrough in patients with gastroesophageal reflux

作　　者：陈吉[1] 王忠[1] 瞿启芬[1] 高美丽[1] 

机构地区：[1]内蒙古包头市内蒙古医学院第三附属医院消化内科,014010

出　　处：《国际消化病杂志》2008年第3期250-252,共3页International Journal of Digestive Diseases

摘　　要：目的探讨胃食管反流病(GERD)患者夜间酸突破(NAB)与食管酸暴露及幽门螺杆菌(Hp)感染的关系及临床意义。方法GERD患者随机分为两组,每组26例,每组给予埃索美拉唑20mg,每日2次,其中1组睡前加服雷尼替丁150mg,疗程1周。两组治疗前后行24h食管pH检测及食管症状评分并进行比较。结果埃索美拉唑组,加服雷尼替丁组治疗后夜间胃pH小于4.0的时间百分比分别为37%、15%,显著低于治疗前90%、90%,后者夜间胃pH小于4.0的中位时间百分比显著低于前者(P<0.05)。加服雷尼替丁组NAB发生率为15.1%,埃索美拉唑组为34.5%,两组比较有统计学意义(P<0.05),两组治疗前后夜间食管pH小于4的中位时间百分比差异无统计学意义(P>0.05),其症状积分比较差异有统计学意义(P<0.05)。合计34例Hp阳性中有7例(20.5%)发生NAB,而18例Hp阴性者中10例出现NAB(55.6%,P<0.05)。结论在胃食管反流中,中国人NAB发生率较低,食管酸抑制和症状控制不依赖于NAB的消除程度,NAB与Hp感染密切相关。Objective To assess the incidence of nocturnal acid breakthrough（NAB） and its relationship with esophageal acid exposure and Hp infection in patients with gastroesophageal reflux （GER）. Methods Fifty two GER patients were randomly allocated into two groups. The patients were treated with esomeprazole 40 mg twice daily orally and omeprazole 40 mg twice and ranitidine 150 mg once daily. Intragastrie pH over 24 hours was recorded on the eighth day and esophageal symptom scores were evaluated for each patients. Results In comparison with that in two groups,intragastric pH was higher in after than that in before treatment, respectively. The percentage of fraction time of pH below 4.0 in group esomeprazole was much lower than that in group esomeprazole plus ranitidine. The ineideuce of NAB in group esomeprazole（34.5%） was significantly higher （P〈0.05）and symptom scores were greatly improved in groups esomeprazole plus ranitidine. The incidence of NAB in Hp negative patients （55.6%） was significantly higher than that in Hp positive patients （20.5%, P〈0.05） . Conclusion NAB occurred less common in Chinese patients with GER than patients in western countries. Acid reflux and symptoms in patients with GER do not dependence NAB status. Hp infection are closely related to the incidence of NAB.

关 键 词：胃食管反流 夜间酸突破 埃索美拉唑 

分 类 号：R571[医药卫生—消化系统]