铝碳酸镁联合奥美拉唑治疗COPD合并胃食管反流病的疗效及对胃动素、胃泌素水平的影响

Effect of hydrotalcite combined with omeprazole on COPD complicated with gastroesophageal reflux and its influence on plasma motilin and serum gastrin levels

目的探讨分析铝碳酸镁联合奥美拉唑治疗慢性阻塞性肺疾病(COPD)合并胃食管反流病(GERD)的疗效及对患者血浆胃动素(MTL)、血清胃泌素(GAS)水平的影响.方法选择COPD稳定期合并GERD患者108例,随机分为观察组56例和对照组52例.对照组给予常规COPD治疗,观察组在对照组基础上给予铝碳酸镁联合奥美拉唑治疗.比较两组治疗前后反流性疾病问卷(RDQ)评分、圣乔治呼吸问卷(SGRD)评分、肺功能指标、6 min步行距离变化以及患者血浆MTL、血清GAS水平变化,并分析患者随访1年COPD急性加重期(AECOPD)发作率.结果观察组患者治疗后RDQ评分低于治疗前,差异有统计学意义(t=8.97,P<0.05),SGRQ各维度及总分均低于治疗前和对照组治疗后,差异均有统计学意义(t分别=7.62、6.59、11.39、10.13;1.98、1.67、2.05、1.70,P均<0.05).观察组患者治疗后第1秒用力呼气容量(FEV1)、第1秒用力呼气容量与肺活量比值(FEV1/FVC)以及6 min步行距离均明显高于治疗前,且明显高于对照组治疗后,差异均有统计学意义(t分别=5.35、6.45、12.09、1.98、1.66、1.99,P均<0.05).观察组患者治疗后血浆MTL、血清GAS均高于治疗前和对照组治疗后,差异均有统计学意义(t分别=8.77、10.35、1.65、1.98,P均<0.05).随访1年,观察组AECOPD发作率为明显低于对照组(χ2=4.43,P<0.05).结论铝碳酸镁联合奥美拉唑可有效改善COPD合并GERD患者胃食管反流症状,并有助于提高肺功能,降低MTL、GAS水平,同时有助于降低AECOPD发作率.

Objective To investigate the effect of hydrotalcite combined with omeprazole on chronic obstructive pulmonary disease(COPD) complicated with gastroesophageal reflux disease(GERD) and the influence on plasma motilin(MTL)and serum gastrin(GAS).Methods Totally 108 COPD patients with GERD were selected and randomly divided into observation group(56 cases)and control group(52 cases).The control group was received conventional COPD treatment,while the observation group was given hydrotalcite combined with omeprazole on the basis of the control group.The reflux disease questionnaire(RDQ),SGRD,pulmonary function index,6-minute walking distance,plasma MTL,and serum GAS levels were compared between the two groups before and after treatment.The incidence of acute exacerbation of COPD(AECOPD)was analyzed after 1-year follow-up. Results After treatment,the RDQ score of the observation group was lower than that before treatmen(tt=8.97,P<0.05),and the SGRQ dimensions and total scores were lower than that before treatment and the control group(t=7.62,6.59,11.39,10.13;1.98,1.67,2.05,1.70,P<0.05).After treatment,the FEV1,FEV1/FVC,and 6-minute walking distance in the observation group were significantly higher than those before treatment and the control group(t=5.35,6.45,12.09,1.98,1.66,1.99,P<0.05). After treatment,the plasma MTL and serum GAS in the observation group were higher than those before treatment and the control group(t=8.77,10.35,1.65,1.98,P<0.05).Following up for 1 year,the incidence of AECOPD in the observation group was significantly lower than that in the control group(χ2=4.43,P<0.05).Conclusion Hydrotalcite combined with omeprazole can effectively i-mprove the symptoms of gastroesophageal reflux in COPD patients with gastroesophageal reflux,improve the lungfunction of patients,effectively reduce the levels of MTL and GAS,and reduce the incidence of AECOPD in patients.