非糜烂性胃食管反流病食管酸暴露特点和雷贝拉唑试验的诊断价值  

Esophageal acid exposure characteristic of non-erosive gastroesophageal reflux disease and diagnostic value of rabeprazole test

作　　者：韦凯扬[1] 

机构地区：[1]广西百色市人民医院消化内科,广西百色533000

出　　处：《胃肠病学和肝病学杂志》2014年第11期1271-1274,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨各型非糜烂性胃食管反流病食管酸暴漏特点及雷贝拉唑试验的诊断价值。方法选取2013年2月-2013年6月百色市人民医院收治的非糜烂性胃食管反流病患者65例,其中异常酸反流型患者25例作为观察组1,食管对酸高敏型患者22例作为观察组2,功能性烧心型患者18例作为观察组3。采用雷贝拉唑10 mg,口服,2次/d,2周为1个疗程,观察3组的酸暴漏特点、症状评分及雷贝拉唑诊断试验敏感性和特异性。结果 (1)酸暴漏特点:观察组1的24 h酸反流次数、长反流次数、p H<4时间及百分比均明显高于其他两组(P<0.05)。(2)症状积分:治疗前3组的典型症状积分与总积分相比,差异均无统计学意义(P>0.05),观察组2的食管外症状积分明显高于其他两组(P<0.05)。治疗1周和2周后,观察组1和观察组2的症状积分均较治疗前明显下降,而观察组3虽较治疗前稍有下降,但差异无统计学意义(P>0.05);治疗2周后观察组1的症状积分明显优于其他两组(P<0.05)。(3)雷贝拉唑诊断试验疗效:治疗1周和2周后的总有效率分别为58.5%和67.7%;观察组1最佳,其次为观察组2和观察组3,差异具有统计学意义(P<0.05);观察组1和观察组2在治疗1周时其雷贝拉唑诊断试验的敏感性和特异性分别为74.5%(35/47)、83.3%(15/18),在治疗2周时分别为87.2%(41/47)、83.3%(15/18)。结论异常酸反流型患者的酸暴漏特点为酸反流和长反流的次数增多,p H<4的时间延长;酸高敏型患者更容易发生食管外症状;雷贝拉唑试验诊断非糜烂性胃食管反流病简单、安全且准确率高,值得临床推广应用。Objective To investigate the esophageal acid exposure characteristic of non-erosive gastroesophageal reflux disease and diagnostic value of rabeprazole test.Methods Sixty-five cases with non-erosive gastroesophageal reflux disease were selected from Feb.2013 to Jun.2013,25 patients with abnormal acid reflux as observation group 1,22patients with esophageal highly sensitive to acid as observation group 2,18 patients with functional heartburn as observation group 3.Give rabeprazole 10 mg,gal,two times a day,2 weeks for one course.The acid exposure characteristic,symptom scores and sensitivity and specificity of the rabeprazole diagnostic test among three groups were observed.Results （1） Acid exposure characteristic：acid reflux times of 24 hours,long reflux times,pH ＜ 4 times and percentage of observation group 1 were significantly higher than those of the other two groups （P ＜ 0.05） ; （2） Symptom scores：the typical symptom scores and total scores of three groups before treatment had no statistical significance （P ＞ 0.05）,the extraesophageal symptom score of observation group 2 was obviously higher than that of the other two groups （P ＜0.05）.The symptom scores of observation group 1 and group 2 were significantly decreased at the first and second week after treatment （P ＜ 0.05）.Despite the observation group 3 had a slight decline,but had no statistical significance （P ＞ 0.05）.The symptom score of the observation group 1 was better than the other two groups at the second week after treatment （P ＜ 0.05）.（3） The rabeprazole diagnostic test effect：the total effective rates were 58.5％ and 67.7％ at the first and second week after the treatment,respectively.Observation group 1 was best,followed by group 2 and group 3 （P ＜ 0.05）.The sensitivity and specificity of rabeprazole diagnostic test of the observation group 1 and group 2 were 74.5％ （35/47）,83.3％ （15/18） at the first week after treatment,87.2％ （41/47）,83.3％ （15/18） at the second

关 键 词：胃食管反流病 雷贝拉唑 诊断 

分 类 号：R57[医药卫生—消化系统]