Todd J A, Basu K K, de Caestecker J S
Digestive Diseases Centre, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester LE5 4PW, UK.
Aliment Pharmacol Ther. 2005 Apr 15;21(8):969-75. doi: 10.1111/j.1365-2036.2005.02406.x.
Proton-pump inhibitors are effective at preventing the acid component of gastro-oesophageal refluxate from entering the oesophagus. It is not clear whether proton-pump inhibitors prevent duodenogastro-oesophageal reflux.
To measure oesophageal exposure to duodenogastro-oesophageal refluxate while on proton-pump inhibitors in patients with Barrett's oesophagus.
Twenty-five patients (23 male) with Barrett's oesophagus underwent 24 h oesophageal pH and Bilitec 2000 monitoring while on omeprazole 40 mg/day (n = 19) or omeprazole 60 mg/day (n = 6). All patients were undergoing argon plasma ablation of their Barrett's epithelium as part of a clinical trial and the Bilitec measurements were only carried out after the ablation had been completed.
20 of 25 (80%) patients had a normal oesophageal pH profile. Fifteen of the 25 (60%) had abnormal oesophageal exposure to bile as measured by Bilitec 2000. Of the 20 patients who had a normal 24 h oesophageal pH profile, 11 (55%) had pathological exposure to bile in their oesophagus.
Complete acid suppression does not guarantee elimination of duodenogastro-oesophageal reflux.
质子泵抑制剂能有效防止胃食管反流物中的酸性成分进入食管。目前尚不清楚质子泵抑制剂是否能预防十二指肠-胃-食管反流。
测量巴雷特食管患者服用质子泵抑制剂时食管对十二指肠-胃-食管反流物的暴露情况。
25例（23例男性）巴雷特食管患者在服用40mg/天奥美拉唑（n = 19）或60mg/天奥美拉唑（n = 6）的情况下接受24小时食管pH值和Bilitec 2000监测。作为一项临床试验的一部分，所有患者均接受氩等离子体对其巴雷特上皮的消融治疗，且Bilitec测量仅在消融完成后进行。
25例患者中有20例（80%）食管pH值曲线正常。通过Bilitec 2000测量，25例中有15例（60%）食管胆汁暴露异常。在24小时食管pH值曲线正常的20例患者中，11例（55%）食管胆汁暴露呈病理性。
完全抑制胃酸并不能保证消除十二指肠-胃-食管反流。
