Objective To determine whether 40 mg of esomeprazole daily reduces the incidence of peptic ulcers over 12 weeks of treatment in patients taking low-dose acetylsalicylic acid (ASA). Methods From January 2010 to December 2012, 242 cases of Helicobacter pylori-negative patients who took a low dose of ASA everyday were included. These patients were randomly divided into esomeprazole group and control group. Esomeprazole group was treated with 40 mg of esomeprazole once a day for 12 weeks， and the control group with placebo. The patients were confirmed peptic ulcer by endoscopy at the end of the treatment. Results After 12 weeks, we found that esomeprazole group significantly reduced the proportion of patients at the risk of peptic ulcers and csomeprazole was generally well tolerated. Conclusion Acid-suppressive treatment with esomeprazole 40 mg a day reduced the occurrence of peptic ulcers in patients at risk for ulcer development who were taking low-dose ASA.%目的 观察埃索美拉唑在降低低剂量阿司匹林治疗的老年人中相关溃疡发病率的作用.方法 纳入需长期低剂量服用阿司匹林的患者242例,均经快速尿素酶法检测确认无现症幽门螺杆菌感染,符合纳入标准和不具备排除标准的病人,按奇偶数原则和1:1比例随机分配进入埃索美拉唑组和对照观察组.治疗组晨起餐前口服埃索美拉唑胶囊40mg,每天1次；对照组口服硫糖铝混悬液10ml,每天2次.所有病人观察期限为12周,观察终点后所有纳入研究的病人均需复查胃镜.结果 治疗组中无一例出现阿司匹林相关性溃疡及其他上消化道症状,对照组中有11例出现黑便,7例粪便隐血阳性,5例血红蛋白降低(Hb＜10g/ml),5例出现消化性溃疡.结论 埃索美拉唑40 mg/d可以有效降低服用低剂量ASA患者发生内镜下可见消化性溃疡的风险,值得在临床推广.
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