High-dose proton-pump inhibitors as a diagnostic test of gastrooesophageal reflux disease in endoscopic-negative patients
High-dose proton-pump inhibitors as a diagnostic test of gastrooesophageal reflux disease in endoscopic-negative patients
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DOI：
10.1080/003655201750313315
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发表时间：
2001-08-01
影响因子：
1.9
通讯作者：
Hansen, T
中科院分区：
文献类型：
--
作者：
Juul-Hansen, P;Rydning, A;Hansen, T
背景：评估高剂量质子泵抑制剂作为内镜检查阴性且出现胃食管反流病症状的患者的诊断测试。方法：采用交叉设计，对 64 名患者进行了前瞻性、随机、双盲研究。经过一段记录基本 CORD 症状的日记并记录抗酸药片消耗量的磨合期后，患者每天一次服用 60 毫克兰索拉唑，或按随机顺序服用安慰剂。记录症状，并服用抗酸药片以缓解疼痛。 CORD 通过 24 小时食管 pH 监测来确定。与治疗前相比，当抗酸药片的消耗量减少大于或等于 75% 时，检测结果为阳性。结果：在 GORD 组中，积极治疗期间有 29 人 (85%) 检测呈阳性，而服用安慰剂时有 3 人 (9%) 检测呈阳性。非 GORD 患者的相应数字为 50% 和 27%，测试敏感性和特异性分别为 85% 和 73%。在积极治疗期间，与非 GORD 组仅出现胃灼热相比，CORD 患者的胃酸反流、胃灼热等 VAS 评分显着降低。结论：60 mg 兰索拉唑每日一次，持续 5 天是一种在内镜检查阴性患者中诊断 CORD 的简便方法。以24小时食管pH监测为参考方法，敏感性较高，但特异性较低。需要进一步研究来确定如何将 PPI 用作 GORD 的诊断测试。
Background: To evaluate a high dose of a proton-pump inhibitor as a diagnostic test in endoscopy-negative patients presenting with symptoms indicating gastro-oesophageal reflux disease. Methods: 64 patients were studied in a prospective, randomized, double-blind study, using a cross-over design. After a run-in period with the diary registration of basic CORD symptoms and recording of the consumption of antacid tablets, the patients were given either 60 mg of lansoprazole once daily or placebo in randomized order. Symptoms were recorded, as well as antacid tablets taken in order to relieve pain. CORD was determined by 24-h oesophageal pH monitoring. The test was considered positive when consumption of antacid tablets was reduced greater than or equal to 75% compared to pretreatment. Results: In the GORD group, 29 (85%) tested positive during active treatment compared to 3 (9%) when on placebo. Corresponding figures for the non-GORD patients were 50% and 27%, giving a test sensitivity and specificity of 85% and 73%, respectively. During active treatment, VAS scores for acid regurgitation, heartburn and over all were significantly lowered in CORD patients, compared to heartburn only in the non-GORD group. Conclusions: 60 mg lansoprazole once daily for 5 days is an easy to use method fur diagnosing CORD in endoscopy-negative patients. Using 24-h oesophageal pH monitoring as the reference method, the sensitivity was relatively high, while the specificity was lower. Further studies are needed to determine how a PPI could be used as a diagnostic test in GORD.