2020 年第 12 期 第 15 卷

埃索美拉唑联合莫沙必利对反流性食管炎患者血清胃泌素和胃蛋白酶原及炎症因子水平的影响

Effect of esomeprazole combined with mosapride on serum gastrin, pepsinogen and inflammatory factor levels in patients with reflux esophagitis

作者：张旭

英文作者：Zhang Xu

单位：浙江医院急诊科，杭州310012

英文单位：Department of Emergency Zhejiang Hospital Hangzhou 310012 China

关键词：反流性食管炎；埃索美拉唑；莫沙必利；胃泌素；胃蛋白酶原；炎症因子

英文关键词：Refluxesophagitis;Esomeprazole;Mosapride;Gastrin;Pepsinogen;Inflammatoryfactors

• 摘要：

• 目的 观察埃索美拉唑联合莫沙必利对反流性食管炎患者血清胃泌素和胃蛋白酶原及炎症因子水平的影响。方法 选取2017年1月至2018年12月在浙江医院诊治的反流性食管炎患者130例为研究对象。完全随机方法分为对照组和观察组，各65例。对照组给予埃索美拉唑治疗，观察组给予埃索美拉唑联合莫沙必利治疗，2组均治疗2个月。比较2组患者的临床治疗效果，治疗前后血清胃泌素、胃蛋白酶原及炎症因子水平，以及不良反应发生率。结果 观察组总有效率高于对照组［93.8%（61/65）比81.5%（53/65）］，差异有统计学意义(P<0.05)。治疗后2组反酸、烧心、胸骨后疼痛症状评分均较治疗前降低，且观察组低于对照组，差异均有统计学意义（均P<0.05）。治疗后，2组胃蛋白酶原Ⅰ水平均较治疗前升高，且观察组高于对照组［（124.8±12.9）μg/L比（102.9±12.8）μg/L］，胃蛋白酶原Ⅱ、胃泌素17、白细胞介素（IL）-1β、IL-2、IL-6水平均较治疗前降低且观察组低于对照组［（15.2±3.0）μg/L比（20.1±3.0）μg/L、（15.2±2.8）pmol/L比（18.1±3.0）pmol/L、（33±6）ng/L比（46±6）ng/L、（31±4）ng/L比（42±7）ng/L、（28±4）ng/L比（40±5）ng/L］，差异均有统计学意义（均P<0.05）。2组不良反应发生率均为4.6%（3/65），差异无统计学意义（P>0.05）。结论 埃索美拉唑联合莫沙必利治疗反流性食管炎临床效果明显，且能显著改善患者血清胃泌素、胃蛋白酶原及炎症因子水平而不增加不良反应。

• Objective To observe the effect of esomeprazole combined with mosapride on serum gastrin, pepsin and inflammatory factor levels in patients with reflux esophagitis. Methods Totally 130 patients with reflux esophagitis admitted to Zhejiang Hospital from January 2017 to December 2018 were enrolled. The patients were randomly divided into control group and observation group, with 65 cases in each group. The control group received esomeprazole treatment; the observation group received esomeprazole combined with mosapride treatment; both groups were treated for 2 months. The clinical therapeutic effect of the two groups, the levels of serum gastrin, pepsinogen and inflammatory factors before and after treatment and incidence of adverse reactions were compared. Results The total effective rate of observation group was significantly higher than that of the control group［93.8%（61/65） vs 81.5%（53/65）］(P<0.05). After treatment, the scores of acid reflux, heartburn, and post-sternal pain in both groups were lower than those before treatment and those in observation group were lower than those in the control group (all P<0.05). After treatment, the level of pepsinogen I in the two groups were higher than those before treatment and that in observation group was higher than that in the control group［（124.8±12.9）μg/L vs （102.9±12.8）μg/L］; the levels of pepsinogen Ⅱ, gastrin 17, interleukin (IL)-1β, IL-2 and IL-6 in observation group were lower than those before treatment and those in control group［（15.2±3.0）μg/L vs （20.1±3.0）μg/L, （15.2±2.8）pmol/L vs （18.1±3.0）pmol/L, （33±6）ng/L vs （46±6）ng/L, （31±4）ng/L vs （42±7）ng/L, （28±4）ng/L vs （40±5）ng/L］(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）. Conclusion sEsomeprazole combined with mosapride shows good clinical effect on reflux esophagitis. This therapy can significantly restore the levels of serum gastrin, pepsinogen and inflammatory factors without increasing adverse reactions.