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质子泵抑制剂(PPI)是目前治疗胃食管反流病(GERD)最有效的药物之一,但仍有少部分患者对PPI治疗失效。PPI失效的常见原因有患者的依从性差,不同类型GERD对PPI治疗反应差异,肝药酶P4502C19的基因差异及幽门螺杆菌的影响。对PPI治疗失效的患者应行胃镜和食管测压、24h食管pH测定,再决定采用增加PPI剂量,改换不影响P450药敏的药物,加服H2RA或胃动力药、手术等不同方法。
Proton pump inhibitor (PPI) is currently one of the most effective drugs for the treatment of gastroesophageal reflux disease (GERD), but there are still a few patients who fail the PPI treatment. PPI failure of the common causes of poor patient compliance, different types of GERD response to PPI differences in liver enzymes P4502C19 genetic differences and the impact of Helicobacter pylori. Patients with PPI failure should be endoscopy and esophageal manometry, 24h esophageal pH determination, and then decided to increase the dose of PPI, change the drug does not affect the sensitivity of P450, plus take H2RA or gastric motility drugs, surgery and other different methods.