十二指肠溃疡患者夜间酸突破现象分析  

Nocturnal gastric acid breakthrough in patients with duodenal ulcer

作　　者：沙卫红[1] 李瑜元[1] 聂玉强[1] 戴寿军[1] 佘庆珠[1] 

机构地区：[1]广州市第一人民医院消化内科,510180

出　　处：《中华消化杂志》2001年第12期723-725,共3页Chinese Journal of Digestion

摘　　要：目的　探讨十二指肠溃疡患者 (DU)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　十二指肠溃疡患者随机分为五组 ,每组 8例 ,分别接受 :A组 :静脉注射奥美拉唑4 0mg ,每日 2次 ;B组 :静脉注射奥美拉唑 4 0mg ,每日 1次 ;C组 :口服奥美拉唑 2 0mg ,每日 2次 ;D组 :口服奥美拉唑 2 0mg ,每日 1次 ;E组 :静脉注射西米替丁 60 0mg ,每日 2次。均用药 5d并于第 5天早上 8时起连续 2 4h监测其胃内pH值。 结果　五组患者的平均胃内 pH、平均中位 pH、夜间平均胃内pH和夜间平均中位pH均有不同程度升高 ,A组升高明显 ,显著高于B、D、E组 ,差异有显著性 (P <0 .0 5 ) ;B、D、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A、C组 (P <0 .0 5 ) ;五组分别有 0例(A组 ,0 % )、4例 (B组 ,5 0 .0 % )、1例 (C组 ,12 .5 % )、4例 (D组 ,5 0 .0 % )、3例 (E组 ,3 7.5 % )患者发生NAB ;奥美拉唑 2次用药组 (包括静脉和口服用药组 )仅有 1例NAB发生 ( 6.3 % ) ,显著低于 1次用药组(包括静脉和口服用药组 ,5 6.3 % ,P <0 .0 5 ) ;合计 18例Hp阴性者中有 10例 ( 5 5 .6% )发生NAB ,2 2例Hp阳性者中只有 3例 ( 13 .6% ,P <0 .0 5 )。 结论　DU患者中 ,中国人的NAB发生率低 ,NAB与奥美拉唑剂量、Objective To assess the incidence of noctu rnal acid breakthrough(NAB) and its' relationship with Helicobacter pylori(H. pylori) infection in patients with duodenal ulcer. Methods Forty duodenal ulcer patients were randomly allocated in to five groups. Patients were treated by intravenous injection of omeprazole 40 mg twice daily(group 1), once daily(group 2), omeprazole 20 mg twice daily oral ly(group 3), omeprazole 20 mg once daily orally(group 4), and intravenous inject ion of cimetidine 600 mg twice daily (group 5) all for 5 days. Intragastric pH o ver 24 hours was consecutively recorded on the fifth day for each patient. Results The mean intragastric pH, median intragastric pH, nocturn al mean pH and nocturnal median pH in group 1(6.9±0.7,7.3±0.8,6.8±0.9,7.1± 0 .7) were significantly higher than those of group 2 (5.3±1.6,5.6±1.7,4.9±1. 5,4.3±1.7),group 4(4.8±0.7,4.8±1.0,4.7±0.8,4.5±0.8), and group 5(4.4±2.4 ,4.5±2.5,4.6±2.7,4.3±2.1), but not higher than group 3(6.2±0.7,6.3±0.8,6. 4±1.1,6.4±0.8). High intragastric pH was produced in all five groups. The frac tion time of pH below 4.0 in group 1(3.1%) and group 3(4.5%) were significantly fewer than that in the other three groups(group 2,27.8%; group 4, (32.4)%, and group 5,48.2%) respectively. NAB occurred in 1 patient from two omeprazole twice dai ly groups(6.3 %, group 1 and 3) and in 9 patients from two omeprazole once daily groups((56.3 %,) group 2 and 4,P<0.05). The incidence of NAB in H. pylori negative pat ients (55.6%) was significantly higher than that in H. pylori positive(13.6% ) patients(P<0.05). Conclusions (NAB) (occurred) less common in Chinese patients w ith duode nal ulcer than patients in western countries. (Dose) (and) (methods) of omeprazole adm inistration and the status of H.pylori infection status appeared to be (clo sely) (related) to the (incidence) of NAB.

关 键 词：十二指肠溃疡 夜间酸突破 奥美拉唑 西米替丁 幽门螺杆菌感染 

分 类 号：R575[医药卫生—消化系统]