不同尿素呼气试验值阴转后胃食管反流病的治疗随访

目的　观察幽门螺杆菌不同尿素呼气试验 ( UBT)值阴转后在胃食管反流病人中对抑酸剂的影响。方法　症状积分法≥ 6分为反流阳性。1 4C- U BT值≥ 10 0 dm p/ m mol CO2 诊断幽门螺杆菌阳性。观察组按不同 1 4C- UBT阳性值分为 3个组 ,对照组 1 4C- UBT阴性。排除胃、十二指肠溃疡、手术、Barrett′s食管和食管裂孔疝。随访 :每 4周 1次 ,观察奥美拉唑( om eprazole)改为尼扎替定 ( nizatidine)后效果 ,共随访 5次。结果　改服尼扎替定后 UBT值最高组阴转后症状积分降低和有效率显著高于 U BT低值组和对照组 ( P<0 .0 5 )。结论　胃食管反流病合并 U BT高值组 ( >3 0 0 dpm / m mol CO2 )阴转后可以降低用药强度 ;效果在 8周后逐渐增加

Treatment follow-up to the gastroesophageal reflux disease patients after Helicobacter pylori eradication based on varied values of urea breath test

Objective To observe the influence of Helicobacter pylori UBT values (turned negative) on the antacid used in patients with gastroesophageal reflux disease (GERD).Method GERD was defined as ≥6 scores,which was obtained according to reflux symptoms,namely extent and frequency of heartburn,regurgitation and/or food reflux (mild and several times per month scored 1,moderate and several times per week scored 2,severe and several times per day scored 3).The patients with previous gastroduodenal ulcer esophageal surgery,Barrett′s syndrome,hiatal hernia and peptic ulcer were excluded.Patients for study were subdivided into three groups according to the varied values of UBT as Hp positive.Patients for control were Hp negative.Follow ups were five times,one per 4 weeks,to investigate the effect of changing the drug from omeprazole to nizatidine after Hp eradication.Results There was a more significant improvement in the patients with GERD coinciding with the highest value UBT than that in those with the lowest UBT value and in the control on the basis of symptoms′ scores and cure rates.Conclusion GERD patients coinciding with the highest UBT value (>300 dpm/mmol CO 2)may reduce the dosage of antacids (change ameprazole to nizatidine),their curative effect strengthens gradually after an eight week′s time.