S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Aliment Pharmacol Ther. 2011 Feb;33(4):466-70. doi: 10.1111/j.1365-2036.2010.04545.x. Epub 2010 Dec 15.
Gastro-oesophageal reflux is common in preterm newborns; at present, no studies have evaluated the efficacy of sodium alginate in this population.
To evaluate the effect of sodium alginate on gastro-oesophageal reflux features in preterm newborns by combined pH and impedance monitoring (pH-MII).
Thirty-two symptomatic preterm newborns underwent a 24 h pH-MII, during which each baby was fed eight times. Sodium alginate was given four times at alternate meals [drug-given (DG) vs. drug-free (DF) meals]. Gastro-oesophageal reflux features (i.e. number, acidity, duration and height of gastro-oesophageal reflux) after DG and DF meals were compared by Wilcoxon signed ranks test.
Sodium alginate significantly decreased the number of acid gastro-oesophageal reflux detected either by pH monitoring (DG vs. DF: median 17.00 vs. 29.00, P = 0.002) and MII (DG vs. DF: 4.0 vs. 6.00, P = 0.050), and also acid oesophageal exposure (DG vs. DF: 4.0% vs. 7.6%, P = 0.030), without any influence on non-acid gastro-oesophageal reflux. Furthermore, it decreased the number of gastro-oesophageal reflux reaching proximal oesophagus (DG vs. DF: 5.50 vs. 7.50, P = 0.030).
The use of sodium alginate in preterm infants seems to be promising, because this drug decreases gastro-oesophageal reflux acidity and height with the advantage of a nonsystemic way of action and a more favourable safety profile over H2 blockers and PPIs.
胃食管反流在早产儿中很常见；目前，尚无研究评估海藻酸钠在该人群中的疗效。
通过联合 pH 和阻抗监测（pH-MII）评估海藻酸钠对早产儿胃食管反流特征的影响。
32 例有症状的早产儿进行了 24 小时 pH-MII 检查，在此期间，每个婴儿喂食 8 次。海藻酸钠在 4 次喂食时（用药组 [DG] 与无药组 [DF]）交替给予。通过 Wilcoxon 符号秩检验比较 DG 和 DF 餐后胃食管反流特征（即胃食管反流次数、酸度、持续时间和高度）。
海藻酸钠显著减少了 pH 监测（DG 与 DF：中位数 17.00 比 29.00，P = 0.002）和 MII （DG 与 DF：4.0 比 6.00，P = 0.050）检测到的酸胃食管反流次数，也减少了酸食管暴露（DG 与 DF：4.0%比 7.6%，P = 0.030），但对非酸胃食管反流没有影响。此外，它还减少了到达食管近端的胃食管反流次数（DG 与 DF：5.50 比 7.50，P = 0.030）。
海藻酸钠在早产儿中的应用似乎很有前景，因为这种药物可以降低胃食管反流的酸度和高度，且具有非系统性作用方式和比 H2 阻滞剂和质子泵抑制剂更有利的安全性特征。
