目的 探讨伏诺拉生治疗重症反流性食管炎(RE)的疗效及其对胃泌素和炎症因子的影响。方法 选取2021-02至2022-02在武警安徽总队医院消化科门诊确诊为重症RE患者62例,随机分为伏诺拉生组(31例)和对照组(31例)。伏诺拉生组采用伏诺拉生和依托必利治疗,对照组采用雷贝拉唑和依托必利治疗。比较两组治疗后临床有效率,以及治疗前后内镜评分、胃泌素、TNF-α、IL-6。结果 伏诺拉生组的有效率为87.10%,显著高于对照组(64.52%),差异有统计学意义(χ2=4.309,P＜0.05);治疗后,两组内镜评分(0.30±0.13, 0.64±0.26)均明显低于治疗前(3.42±0.51,3.38±0.48),并且伏诺拉生组改善得更显著(t=-6.51,P＜0.01)。伏诺拉生组的胃泌素水平[(88.93±11.37) pg/ml]明显高于对照组[(60.78±7.98) pg/ml],而TNF-α[(5.95±0.68) pg/ml]、IL-6[(5.55±0.67) pg/ml]水平明显低于对照组[(7.88±0.99)pg/ml,(8.24±0.92)pg/ml],且差异均有统计学意义(P＜0.01)。两组均发生1例不良反应(3.23%)。结论 伏诺拉生治疗重症RE可明显提升有效率,可修复损伤的胃黏膜,同时可显著调整血清胃泌素及炎症因子水平而不增加不良反应。
Abstract
Objective To explore the efficacy of vonoprazan in the treatment of severe reflux esophagitis (RE) and its effects on gastrin and inflammatory factors.Methods Sixty-two patients who were diagnosed with severe RE in the gastroenterology clinic of Anhui Provincial Corps Hospital of Chinese People's Armed Police Force from February 2021 to February 2022 were selected and randomly divided into two groups: vonoprazan group (31 cases) and control group (31 cases).The vonoprazan group was treated with vonoprazan and Itopride,while the control group with rabeprazole and itopride. Post-treatment clinical response rate was compared between the two groups, as well as the endoscopic scores, gastrin, TNF(tumor necrosis factor), and IL-6(Interleukin-6) before and after the treatment.Results The effective rate of the vonoprazan group was 87.10%, which was significantly higher than that of the control group (64.52%) (χ2=4.309, P<0.05). After treatment, both endoscopic scores (0.30±0.13, 0.64±0.26) were significantly lower than those before treatment (3.42±0.51, 3.38±0.48) and improved more significantly in the vonoprazan group (t=-6.51, P<0.01). The level of gastrin in vonoprazan group [(88.93±11.37) pg/ml] were significantly higher than that of the control group [(60.78±7.98) pg/ml], while the levels of TNF [(5.95±0.68) pg/ml] and IL-6 [(5.55±0.67) pg/ml] were significantly lower than those in the control group[(7.88±0.99)pg/ml,(8.24±0.92)pg/ml], and the differences were all statistically significant (P<0.01). Both groups had one adverse reaction (3.23%).Conclusions Vonoprazan in the treatment of severe RE can significantly improve the efficiency, repair the damaged gastric mucosa, and significantly adjust the serum gastrin and inflammatory factor levels without increasing the adverse effects.
关键词
反流性食管炎 /
伏诺拉生 /
胃泌素 /
炎症因子
Key words
reflux esophagitis /
vonoprazan /
gastrin /
inflammatory factors
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