Sontag S J, Schnell T G, Chejfec G, Kurucar C, Karpf J, Levine G
Department of Medicine, Loyola University of Chicago Stritch School of Medicine, Maywood, Illinois, USA.
Aliment Pharmacol Ther. 1997 Feb;11(1):147-56. doi: 10.1046/j.1365-2036.1997.114285000.x.
Barrett's oesophagus is thought to be a complication of severe gastro-oesophageal reflux.
To determine whether the proton pump inhibitor, lansoprazole, is effective in healing erosive reflux oesophagitis in patients with Barrett's oesophagus.
An 8-week, randomized, double-blind study was conducted using patients with both erosive reflux oesophagitis and Barrett's oesophagus. Erosive reflux oesophagitis was defined as grades 2-4 oesophagitis; Barrett's oesophagus, as specialized columnar epithelium obtained by biopsy from the tubular oesophagus; and healing, as a return to grade 0 or 1 oesophageal mucosa (complete re-epithelialization). One-hundred and five (105) patients from one centre were randomized to receive either lansoprazole 30 mg daily or ranitidine 150 mg twice daily. Unhealed or symptomatic lansoprazole patients at week 4 were randomized to receive the same 30 mg dose daily or an increased dose of 60 mg daily. Endoscopy was performed at baseline and at weeks 2, 4, 6 and 8.
The treatment groups were similar in regards to baseline characteristics, erosive reflux oesophagitis grades and length of Barrett's oesophagus. At each 2-week interval, lansoprazole patients had significantly greater healing rates and less day and night heartburn and regurgitation than ranitidine patients. There were no significant differences between treatment groups in antacid use, quality of life parameters, or rate of reported adverse events. Median values for fasting serum gastrin levels remained within the normal range for both groups.
In patients with both Barrett's oesophagus and erosive reflux oesophagitis, lansoprazole is significantly more effective than ranitidine in relieving reflux symptoms and healing erosive reflux oesophagitis.
巴雷特食管被认为是严重胃食管反流的一种并发症。
确定质子泵抑制剂兰索拉唑对巴雷特食管患者糜烂性反流性食管炎的愈合是否有效。
对患有糜烂性反流性食管炎和巴雷特食管的患者进行了一项为期8周的随机双盲研究。糜烂性反流性食管炎定义为2 - 4级食管炎；巴雷特食管定义为从管状食管活检获得的特殊柱状上皮；愈合定义为食管黏膜恢复到0级或1级（完全重新上皮化）。来自一个中心的105名患者被随机分为两组，一组每天接受30毫克兰索拉唑治疗，另一组每天两次接受150毫克雷尼替丁治疗。第4周时未愈合或有症状的兰索拉唑治疗患者被随机分为两组，一组继续每天接受相同的30毫克剂量治疗，另一组每天增加至60毫克剂量。在基线以及第2、4、6和8周进行内镜检查。
治疗组在基线特征、糜烂性反流性食管炎分级和巴雷特食管长度方面相似。在每2周的间隔时间内，兰索拉唑治疗的患者比雷尼替丁治疗的患者愈合率显著更高，白天和夜间烧心及反流症状更少。治疗组在使用抗酸剂、生活质量参数或报告的不良事件发生率方面没有显著差异。两组空腹血清胃泌素水平的中位数均保持在正常范围内。
对于同时患有巴雷特食管和糜烂性反流性食管炎的患者，兰索拉唑在缓解反流症状和愈合糜烂性反流性食管炎方面比雷尼替丁显著更有效。
