目的 探讨胃食管反流病( GERD)患者夜间酸突破(NAB)与食管酸暴露的关系.方法 将45例GERD患者随机分为两组,对照组(21例)给予雷贝拉唑钠10 mg早晚各1次口服,试验组(24例)治疗同对照组外晚间睡前另加服雷尼替丁150 mg,疗程共7d.两组治疗前后行24h食管、胃pH监测,及反流诊断问卷评分(RDQ),并进行比较.结果 加服雷尼替丁组夜间酸突破的发生率为20.83％,单用雷贝拉唑钠组为57.14％,两组比较差异有统计学意义(P＜0.05)；两组治疗前后的夜间食管pH ＜4的中位时间百分比及RDQ评分差异无统计学意义(P＞0.05).结论 食管酸暴露和食管反流症状的控制不依赖于夜间酸突破的缓解,更大程度上取决于食管动力异常的改善.%Objective To discuss the relationship between nocturnal acid breakthrough(NAB) and esophageal acid exposure in patients with gastroesophageal reflux disease(GERD). Methods 45 cases of GERD patients were divided into two groups at random,including experimental group(24 cases) and control group(21 cases). Both of the two groups were given sodium raheprazole 10 mg in the morning and the evening respectively,and experimental group(24 cases) was also given raniti-dine 150 mg at bedtime,7 days as a course. 24 h monitor of esophageal and gastric pH and reflux disease questionnaire( RDQ) scores were compared before and after treatment. Results The rate of NAB in experimental group was 20. 83% ,and the control group's was 57.14% ,the difference was marked(P<0.05).There was no significant difference in the median time percentage of esophageal pH <4 at night and RDQ scores between the two groups before and after treatment P >0.05). Conclusion The control of esophageal acid exposure and gastroesophageal reflux symptoms may not relay on NAB remission, but depend on the improvement of esophageal motion abnormality to a great degree.
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