反流性食管炎患者的症状特征及埃索美拉唑治疗的疗效评估

Symptomatic Characteristics of Patients with Reflux Esophagitis and Evaluation of Efficacy of Esomeprazole

目的:观察不同程度反流性食管炎(RE)的反流症状特点和埃索美拉唑8周治疗的疗效。方法:75例经内镜确诊的RE患者,口服埃索美拉唑40mg,每天1次,共8周。观察不同程度RE患者的反流症状特征以及埃索美拉唑治疗后症状变化和4周、8周后RE治愈率。结果:71例RE患者完成8周疗程。90.6%患者有烧心和反酸,59.2%有胸骨后疼痛。反酸、烧心和胸骨后疼痛发作程度和频率并不随RE程度或频度加重而增加。内镜下RE分为A、B、C、D4级,A+B组和C+D组RE患者的反酸和烧心程度和频度均以中、重度为著,两组间差异无统计学意义(P>0.05)。胸骨后疼痛在不同程度RE患者中发作程度和频率之间差异无统计学意义(P<0.05)。用药第1天,烧心、反酸、胸骨后疼痛症状的消失率和缓解率分别为23.1%、45.3%、39.8%和52.6%、69.1%、71.2%,用药1周后各反流症状消失率和缓解率可高达50%以上和80%以上。8周治疗后复查RE愈合率为96.1%(68/71)。结论:RE患者的症状不因RE程度加重而增加,埃索美拉唑对RE患者的反流症状和RE显示有效和疗效迅速。

OBJECTIVE：To observe the characteristics of reflux symptoms in patients with different degree of reflux esophagitis（RE） and evaluate the efficacy of esomeprazole（treatment for 8 weeks） on RE.METHODS：75 endoscopically confirmed RE patients were assigned to receive esomeprazole（40 mg） q.d for 8 weeks.The characteristics of reflux symptoms in patients with different degree of RE and the changes of symptoms after treatment with esomeprazole for 8 weeks as well as the cure rate of RE at 4 and 8 weeks were followed.RESULTS：71 RE patients completed 8-week treatment.At baseline,90.6% of patients complained of heartburn and sour regurgitation and 59.2% complained of chest pain.The severity and frequency of sour regurgitation,heartburn and retrosternal pain did not increase as the severity and frequency of RE increased.The severity and occurring frequency of reflux symptoms in（A＋B） group and（C＋D） group appeared predominantly as intermediate-severe degree,however,the differences between the two groups were not significant（P〉0.05）.There were no significant differences between patients with different degree of RE in respect of the severity and frequency of retrosternal pain（P〈0.05）.On day 1 of medication,the disappearance rates of heart burn,acid regurgitaion and chest pain were 23.1%,45.3%,39.8%,respectively and the remission rates of which were 52.6%,69.1% and 71.2%,respectively.After treatment for one week,the disappearance rates of heart burn,acid regurgitation and chest pain were all above 50% and the remission rates of which were all above 80%.The cure rate of RE at 8 weeks was 96.1%（68/71）.CONCLUSION：The symptoms of RE wouldn＇t worsen with the worsening of the severity of RE.Esomeprazole is effective for reflux symptoms and it takes effect rapidly.