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Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease

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Chinese Medical Journal 2010年第15期123卷 2012-2017页

作者： PENG Sui XIONG Li-shou XIAO Ying-lian WANG An-jiang LIN Jin-kun HU Pin-jin CHEN Min-hu Division of Gastroenterology & Hepatology the First Affiliated Hospital of Sun Yat-sen University Guangzhou Guangdong 510080 China

Background The relationship between symptom elimination and normalization of esophageal acid level of gastroesophageal reflux disease （GERD） on proton-pump inhibitor （PPI） therapy has been questioned. This study aimed to evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese patients with GERD on esomeprazole therapy, and to assess the role of 24-hour esophageal pH-metry after therapy in GERD *** GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hour esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hour pH-metry after treatment. The pH- group achieved normalization of esophageal pH level whereas the pH＋ group did *** Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 90% （52/58） of symptom-free patients and 67% （12/18） of symptom-persistent patients achieved esophageal pH normalization after therapy （P=0.030）. The mean post-therapy gastric nocturnal percent time of pH 〈4.0 was significantly higher in pH＋group than that in pH- group （P 〈0.001） after therapy. The multivariate regression analysis identified hiatus hernia （P〈0.001） and persistent reflux symptom （P=0.004） were two independent factors predicting the low post-therapy esophageal pH *** symptom elimination is not always accompanied by esophageal pH normalization, and vice *** pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.

关键词： gastroesophageal reflux esomeprazole symptom response esophageal pH level

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