质子泵抑制剂治疗Barrett食管患者24小时ph阻抗及高分辨率食管测压参数的特征

Q3 Medicine
I. Maev, D. S. Bordin, E. Barkalova, M. Ovsepyan, E. Valitova, N. G. Kalashnikova, D. Andreev
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引用次数: 0

摘要

Аim:通过对巴雷特食管患者24小时ph阻抗和高分辨率食管测压结果的评估,确定质子泵抑制剂有效性不足的预测因素。材料和方法。我们对52例经组织学证实的巴雷特食管患者进行了质子泵抑制剂治疗。所有患者均接受每日ph阻抗和高分辨率食管血压测量。根据每日ph阻抗,1组有37例患者对抗分泌治疗反应满意,2组有15例患者对抑酸治疗反应不足,其中11例无临床表现。组1平均反流次数为55次,组2平均反流次数为106次。组1平均胃酸反流次数5.68次,组2平均胃酸反流次数- 48.5次。2组患者出现非胃酸反流的平均次数为58次,1组患者出现非胃酸反流的平均次数为47次。对高分辨率食管测压结果的评估显示,52例患者中有21例检测到食管-胃交界结构和功能的破坏。52例患者中有31例出现胸段食道运动障碍。比较1组和2组胸段食道运动障碍的发生频率,无明显差异。然而,在质子泵抑制剂效果不理想的组中,发现食管胃连接处结构和/或功能破坏的发生率明显更高。在许多巴雷特食管患者中,抑酸治疗效果不足,同时病程无症状,这可能增加其进展的风险。巴雷特食管患者治疗不够成功的预测因素可能是质子泵抑制剂本身的药理作用不足,以及运动障碍导致非酸反流的存在,食管清除率降低,这反过来可能导致患者的症状持续并对食管粘膜状况产生不利影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of the Parameters of 24-Hours pH-Impedance and High-Resolution Esophageal Manometry in Patients with Barrett's Esophagus on Proton Pump Inhibitors
Аim: to identify predictors of insufficient effectiveness of proton pump inhibitors based on the evaluation of the results of 24-hour pH-impedance and high-resolution esophageal manometry in patients with Barrett's esophagus.Materials and methods. 52 patients with histologically confirmed Barrett's esophagus who are on therapy with proton pump inhibitors were examined. All patients underwent daily pH-impedance and high-resolution esophageal manometry.Results. According to daily pH-impedance, group 1 consisted of 37 patients who responded satisfactorily to antisecretory therapy, group 2 of 15 patients who demonstrated insufficient response to acid-suppressive therapy, 11 of whom had no clinical manifestations. The total number of reflux averaged 55 in group 1 and 106 in group 2. The average number of acid reflux in group 1 was 5.68, in group 2 — 48.5. The average number of non-acid reflux prevailed in patients of group 2 and averaged 58, in group 1 the indicator averaged 47. Evaluation of the results of high-resolution esophageal manometry showed that violations of the structure and function of the esophago-gastric junction were detected in 21 patients out of 52. Disorders of the motility of the thoracic esophagus were detected in 31 patients out of 52. When comparing the frequency of motor disorders from the thoracic esophagus in groups 1 and 2, no significant differences were obtained. However, significantly more frequent registration of violations of the structure and/or function of the esophago-gastric junction was found in the group with unsatisfactory effectiveness of proton pump inhibitors.Conclusion. In a number of patients with Barrett's esophagus, there is an insufficient effect of acid-suppressive therapy and at the same time an asymptomatic course of the disease, which may increase the risk of its progression. Predictors of insufficiently successful treatment of patients with Barrett's esophagus may be both insufficient pharmacological effect of proton pump inhibitors themselves, and motility disorders that cause the presence of non-acid reflux, decreased esophageal clearance, which in turn may cause the patient's symptoms to persist and adversely affect the condition of the esophageal mucosa.
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
44
审稿时长
8 weeks
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