目的 探讨泮托拉唑治疗老年人反流性食管炎及预防复发的临床疗效.方法 70例反流性食管炎老年患者随机分为两组,每组35例,A组服用泮托拉唑40 mg,2次/d,B组服用泮托拉唑40 mg,1次/d.8周后,治疗有效的患者共61例,其中26例继续口服泮托拉唑40 mg,1次/d,维持治疗48周,另外35例未继续服用泮托拉唑但同时给予随访,并在8周、24周及48周时分别评价临床症状并复查胃镜.结果 治疗8周后A组、B组的症状缓解有效率分别为91.4％、82.9％,内镜下食管炎改善有效率分别为97.1％、91.4％.维持治疗患者,24周后临床症状和内镜下食管炎缓解的有效率均为84.6％；48周后临床症状缓解的有效率为88.5％,内镜下食管炎改善有效率为84.6％.未维持治疗组24周及48周时临床症状缓解的有效率分别为48.6％、37.1％.结论 泮托拉唑能有效地治疗老年人反流性食管炎及减少复发,维持48周的用药安全、有效.%Objective To evaluate the efficacy of pantoprazole in treating and preventing the reflux esophagitis in elderly subjects. Methods Seventy patients aged 60 years and over 60 years with reflux esophagitis were divided into two groups: group A ( n = 35) was treated with pantoprazole, 40 mg twice daily; group B ( n = 35) was treated with pantoprazole, 40 mg daily. After 8 weeks, Twenty-six of sixty-one patients with documented healing of esophagitis were sequentially treated with pantoprazole, 40 mg daily, for 48 weeks. Clinical evaluations were performed and endoscopy was repeated after 8 weeks, 24 weeks and 48 weeks or henever symptoms suggested a relapse of esophagitis. Thirty-five of sixty-one patients with documented healing of esophagitis who were not treated with pantoprazole or other PPI were followed up. Results After 8 weeks, the symptomatic healing rates of esophagitis were 91.4% and 82.9% in group A and group B, respectively. The endoscopic healing rates of esophagitis were 97. 1% and 91. 4% in group A and group B, respectively. After 24 weeks, the symptomatic and endoscopic healing rates of esophagitis of pantoprazole maintenance therapy were all 84.6%. After 48 weeks, the corresponding value were 88.5% and 84.6% , respectively. The symptomatic healing rates of esophagitis of those none maintenance therapy were 48.6% and 37. 1% , respectively at 24 weeks and 48 weeks. Conclusion In the elderly, pantoprazole is highly effective in healing and reducing the relapse of esophagitis; continuing active treatment for 48 weeks is safe and effective.
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