质子泵抑制剂和胃黏膜萎缩肠上皮化生相关性研究.docVIP

质子泵抑制剂和胃黏膜萎缩肠上皮化生相关性研究 　　【摘要】 目的：研究应用质子泵抑制剂与胃黏膜萎缩、肠上皮化生之间的相关性。方法：将符合纳入标准的本院内科门诊及住院患者分两组，试验组44例，对照组24例。两组患者试验开始前均行14C呼气试验及胃镜检查及病理活检。试验组每天服用质子泵抑制剂抑酸治疗，对照组不采取干预措施，于试验6、12、24个月分别行14C呼气试验及胃镜检查及病理活检。结果：试验组0、6、12、24个月幽门螺杆菌阳性分别为19、5、3、12例，对照组分别为10、2、2、5例，两组幽门螺杆菌感染率在0、6、12、24个月差异无统计学意义。试验组于6个月发现肠上皮化生7例，萎缩性胃炎1例，12个月发现肠上皮化生9例，萎缩性胃炎1例，24个月发现肠上皮化生15例，萎缩性胃炎2例。对照组6个月发现肠上皮化生2例，12个月发生肠上皮化生2例，24个月发现肠上皮化生4例，萎缩性胃炎1例。试验组和对照组6、12、24个月萎缩性胃炎及肠上皮化生发生率比较，差异无统计学意义。结论：长期使用质子泵抑制剂与肠上皮化生及萎缩性胃炎发生无统计学意义上相关性，但有导致肠上皮化生倾向，仍建议密切内镜随访，定期监测幽门螺杆菌感染。 　　【关键词】 质子泵抑制剂； 萎缩性胃炎； 肠上皮化生； 幽门螺杆菌 　　【Abstract】 Objective： To investigate the relationship between the long-term using of proton pump inhibitors and gastric mucosa atrophy and intestinal metaplasia. Method： Outpatient and hospitalized patients met the inclusion criteria in Department of internal medicine in our hospital were divided into two groups randomly， experimental group contained 44 patients， control group 24 patients. Two groups were performed in 14C breath test and gastroscopy and biopsy. The experimental group was treated by proton pump inhibitors for acid suppression therapy， the control group without intervention， in experiment 6， 12， 24 months were performed 14C carbon breath test and gastroscopy and biopsy. Result： The Helicobacter pylori positive patients were 19， 5， 3， 12 cases in the experimental group at 0， 6， 12， 24 months， in the control group were 10， 2， 2， 5 cases respectively. The two groups Helicobacter pylori infection rate had no statistically significant difference at 0， 6， 12， 24 months. The experimental group in 6 months found 7 cases with intestinal metaplasia， and 1 case with atrophic gastritis. In 12 months found 9 cases with intestinal metaplasia， and 1 case with atrophic gastritis. In 24 months found 15 cases with intestinal metaplasia， and 2 cases with atrophic gastritis. The control group in 6 months found 2 cases with intestinal metaplasia. In 12 months found 2 cases with intestinal metaplasia. In 24 months found 4 case