质子泵抑制剂治疗持续不卧床腹膜透析患者胃食管反流症状的疗效观察

Clinical observation on proton pump inhibitor for treatment of gastroesophageal reflux symptom in continuous ambulatory peritoneal dialysis patients

目的评估慢性肾功能衰竭持续不卧床腹膜透析（CAPD）患者的胃食管反流症状及质子泵抑制剂治疗的疗效。方法选取2008年1月至7月一般情况良好、透析充分的CAPD患者58例，采用胃食管反流病诊断问卷（RDQ）评估其胃食管反流症状。RDQ累积评分≥6分且〈12分者给予埃索美拉唑镁肠溶片20mg每日1次，对于RDQ累积评分≥12分者给予上述药物每日2次，每次20mg。4周后再次评估RDQ评分，判断疗效。结果各种消化道症状的出现频率中反流症状出现频率最高（64．7％），其次为反酸（52．9％）、非心源性胸痛（47．1．％）和烧心（17．6％）。PPI治疗4周后RDQ分值较治疗前降低（P〈0．05）；治疗前RDQ评分总分≥12分者和〈12分者疗效比较差异无统计学意义（P=0．059）。结论PPI能缓解CAPD患者的胃食管反流症状，但其疗程以及疗效评估尚需进一步研究证实。

Objective To evaluate the gastroesophageal reflux symptom in patients who underwent continuous ambulatory peritoneal dialysis （CAPD） and the efficacy of proton pump inhibitor （PPI） in treating gastroesophageal reflux. Methods Fifty eight CAPD patients with good clinical and complete dialyzed condition,who was admitted to the hospital between Jan. 2008 and July 2008, were inquired about their gastroesophageal reflux symptoms using reflux disease questionnaire （RDQ）. The patients who had RDQ≥6 and 〈12 were received esomeprazole 20 mg daily, while those with RDQ≥12 were received esomeparzole 20 mg twice daily. RDQ score was reevaluated 4 weeks after treatment. Results The common symptom was regurgitation （64.7 %）, followed by acid reflux （52.9%）, noncardic chest pain （47. 1. %） and heart burn （17. 6%）. After 4-week treatment, the RDQ was significantly decreased （P〈0. 05）. But there was no difference in outcome of treatment between patients with RDQ ≥ 12 and RDQ 〈 12 （ P = 0. 059 ）. Conclusion The gastroesophageal reflux symptom in CAPD patients can be relieved by PPI administration, but a larger clinical trial is needed to evaluate the course and efficacy of treatment.