摘要
目的 探讨质子泵抑制剂奥美拉唑 (商品名 :洛赛克 )试验对胃食管反流病 (GERD)的诊断价值。方法 根据临床反流症状、食管 2 4hpH监测、胃镜检查结果 ,将 15 2例有反流症状的GERD(12 3例 )与非GERD病人 (2 9例 )随机、双盲分成奥美拉唑 2 0mg/d(A组 ,5 0例 )、40mg/d(B组 ,5 1例 )及对照组 (C组 ,5 1例 ,第一周用安慰剂 ,第二周改用奥美拉唑 40mg/d) ,服药时间为 1周和 2周 ,记录服药前后病人烧心、反酸、反食、胸骨后疼痛症状积分的改变 ,按症状积分下降值判定诊断 ,与食管 2 4hpH监测、胃镜检查结果进行对比分析。结果 A、B、C三组的GERD病人 ,服药 1周后反流症状积分下降分别为 :5 .0± 4.8、4.9± 4.6、2 .3± 4.0 ,下降率分别为 35 .5 %、34 .9%、15 .3%。以症状积分下降 2分为标准 ,奥美拉唑试验诊断GERD的价值最佳。不同服药剂量分析 ,2 0mg/d服 1周组 ,试验敏感性、特异性分别为 82 .5 %、40 .0 %,符合率 76 .7%;40mg/d组则分别为88.1%、44 .4%和 81.0 %。两者比较差异无显著性。对服药时间分析 ,则以服奥美拉唑 2 0mg/d 1周为佳。结论 奥美拉唑试验是GERD临床诊断的一种可靠方法。
Objective To observe the diagnostic value of Omeprazole (Losec) test in gastro-esophageal reflux disease. Methods According to clinical manifestations and results of esophageal 24 h pH monitoring and gastro-esophageal endoscopy, 152 patients with reflux symptoms (123 GERD, 29 non-GERD) were randomly, double-blindly divided into group A (Omeprazole 20 mg/d for 1 week), group B(Omeprazole 40 mg/d for 2 weeks), and group C (placebo at the first week, Omeprazole 40 mg/d at the 2 nd week). Symptom score from heartburn, acid regurgitation, food regurgitation, and substernal pain, was recorded before and after taking Omeprazole or placebo. Results After taking Omeprazole 1 week, the symptom score decreasing from GERD patients of group A, B and C was 5.0±4.8、4.9±4.6、2.3±4.0 respectively, score decreasing 2 was the best critical value for GERD diagnosis. There was no difference between Omeprazole 20 mg/d and 40 mg/d for 1 week, the results showed that Omeprazole test (20 mg/d for 1 week) has the best diagnostic value for GERD, the diagnostic sensitivity was 82.5%, specificity was 40.1%, coincident rate was 76.7%. Conclusion Omeprazole test is reliable for GERD diagnosis.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2002年第1期7-10,共4页
Chinese Journal of Digestion