【摘要】 目的观察艾普拉唑肠溶片对合并或不合并食管外症状反流性食管炎患者治疗前后,反流症状,胃动力学指标及临床疗效变化特点。方法前瞻性序贯纳入2019年1月至2020年6月消化内科门诊就诊的合并食管外症状胃食管反流病(GERD)患者44例,未合并食管外症状患者45例。采用艾普拉唑肠溶片10 mg/d, 1次/d,连续治疗12周。比较2组患者治疗前后反流症状量表(RSI)、反流体征指数量表(RFS)、胃食管反流病问卷(GerdQ)评分,采用固态测压和动态食管压力测定法检测2组患者药物治疗前后胃食管动力学指标包括食管上括约肌压力(UESP)、食管下括约肌压力(LESP)、食管上括约肌长度(UESL)、食管下括约肌长度(LESL)、远端收缩积分(DCI)、收缩前沿速度(CFV)、远端潜伏期(DL)、食团内压(IBP),比较2组患者临床疗效。结果药物治疗后,2组患者RSI评分、RFS评分、GerdQ评分均较治疗前降低,未合并食管外症状组患者RSI评分、RFS评分、GerdQ评分低于合并食管外症状组患者,差异有统计学意义(均P<0.05),药物治疗后合并食管外症状组患者胃动力学指标UESP、LESP、DCI、DL与药物治疗前比较,差异有统计学意义(均P<0.05),药物治疗后未合并食管外症状组患者胃动力学指标UESP、LESP、UESL、LESL、DCI、CFV、DL、IBP与药物治疗前比较,差异无统计学意义(均P>0.05),合并食管外症状组患者临床有效率低于未合并食管外症状组患者,差异有统计学意义(P<0.05)。结论艾普拉唑肠溶片能改善未合并食管外症状GERD患者胃食管动力学,临床有效率高于合并食管外症状GERD患者,其原因可能与未合并食管外GERD与合并食管外GERD不同发病机制相关。更多还原

【Abstract】 Objective To investigate the effects of ilaprazole enteric-coated tablets on the esophageal dynamics in gastroesophageal reflux disease(GERD) patients with or without extraesophageal symptoms.Methods A total of 44 GERD patients with extraesophageal symptoms(group A) and 45 patients without extraesophageal symptoms(group B) who visited our hospital from January 2019 to June 2020 were enrolled in the study.The patients were treated by ilaprazole enteric-coated tablets(10 mg/d, bid) for 12 weeks.The reflux symptom index(RSI),reflux finding score(RFS),GERD Questionnaire(GerdQ) scores, and clinical effects were observed and compared between the two groups.Moreover the gastroesophageal dynamic indexes were detected by using solid-state manometry and dynamic esophageal manometry, including upper esophageal sphincter pressure(UESP),lower esophageal sphincter pressure(LESP),length of upper esophageal sphincter(UESL),length of lower esophageal sphincter(LESL),distal contractile integral(DCI),contractile frontal velocity(CFV), distal latency(DL),intrabolus pressure(IBP).Results After drug treatment, the RSI scores, RFS scores and GerdQ scores in both groups were significantly decreased, moreover, which in group B were significantly lower than those in group A(P<0.05). There were significant differences in UESP,LESP,DCI and DL in group A before drug treatment and after drug treatment(P<0.05). However there were no significant differences in UESP,LESP, UESL, LESL,DCI,CFV,DL and IBP in group A before drug treatment and after drug treatment(P>0.05).In addition the clinical effects in group A were significantly lower than those in group B(P<0.05).Conlusion The ilaprazole enteric-coated tablets can improve the gastroesophageal dynamics of GERD patients without extraesophageal symptoms, and its clinical effects are superior to those of GERD patients with extraesophageal symptoms, and the reason may be related to the different pathogenesis between GERD without extraesophageal symptoms and GERD with extraesophageal symptoms.更多还原