艾司奥美拉唑在Hp阳性胃溃疡中的疗效及对胃黏膜形态学的影响

Effect of Esomeprazole in Patients with Hp Positive Gastric Ulcer and Influence for Morphology of Gastric Mucosa

目的:探究艾司奥美拉唑在幽门螺杆菌(Hp)阳性胃溃疡中的疗效及对胃黏膜形态学的影响。方法:将2022年1月—2023年3月厦门大学附属第一医院的80例Hp阳性胃溃疡患者根据随机数字表法分为对照组与观察组,每组40例。两组均进行四联疗法治疗,其中对照组服用奥美拉唑进行治疗,观察组则服用艾司奥美拉唑进行治疗。比较两组的胃溃疡治疗总有效率、症状体征改善时间、Hp根除率、不良反应发生率、治疗前后的胃蛋白酶原[血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)]及胃黏膜形态学指标评分。结果:观察组的胃溃疡治疗总有效率高于对照组,各症状体征改善时间均早于对照组,Hp根除率高于对照组,不良反应发生率低于对照组(P<0.05)。治疗1周及2周后两组的PGⅠ、PGⅡ均低于治疗前,且观察组均低于对照组(P<0.05);治疗8周后两组的各项胃黏膜形态学指标评分均低于治疗前,且观察组均低于对照组(P<0.05)。结论:艾司奥美拉唑在Hp阳性胃溃疡患者中的疗效较好,安全性较高,且可显著改善患者的胃黏膜形态学。

Objective:To investigate the effect of Esomeprazole in patients with Helicobacter pylori(Hp)positive gastric ulcer and influence for morphology of gastric mucosa.Method:A total of 80 patients with Hp positive gastric ulcer from the First Affiliated Hospital of Xiamen University from January 2022 to March 2023 were divided into control group and observation group according to random number table method,with 40 cases in each group.Both groups were treated with quadruple therapy,with the control group receiving Omeprazole and the observation group receiving Esomeprazole.The total effective rates for gastric ulcer,improvement time of symptoms and signs,Hp eradication rates,adverse reaction rates,pepsinogens[serum pepsinogenⅠ(PGⅠ)and pepsinogenⅡ(PGⅡ)]and morphology indexes scores of gastric mucosa before and after the treatment of two groups were compared.Result:The total effective rate of gastric ulcer treatment in the observation group was higher than that in the control group,the improvement time of symptoms and signs were earlier,the eradication rate of Hp was higher than that in the control group,and the incidence of adverse reactions was lower than that in the control group(P<0.05).After 1 week and 2 weeks of treatment,the PGⅠand PGⅡlevels in two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(P<0.05).After 8 weeks of treatment,the scores of gastric mucosa morphological indexes in both groups were lower than those before treatment,and those of the observation group were lower than those of the control group(P<0.05).Conclusion:Esomeprazole has good efficacy and safety in patients with Hp positive gastric ulcer,and can significantly improve gastric mucosa morphology.