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目的观察胃食管反流病(GERD)各亚型在埃索美拉唑治疗前后食管黏膜上皮细胞间隙增宽(DIS)的变化。方法 19例以烧心为主诉、经内镜检查、24h 食管 pH 监测和质子泵抑制剂治疗试验证实为 GERD 的患者,接受埃索美拉唑40 mg/d 治疗2个月。治疗前后内镜检查时在食管齿状线上3～5 cm 处外观正常黏膜取活检,分别进行组织学及透射电镜检查。15例正常人食管黏膜活检电镜检查作为正常参数。结果 2个月治疗后,糜烂性食道炎(6例)、伴有病理性酸反流的 NERD(7例)、不伴有病理性酸反流的 NERD(6例)DIS 恢复正常分别有5例(83.33%)、6例(85.71%)和5例(83.33%),均伴随烧心症状完全消失。DIS 未恢复正常的3例患者中2例烧心症状仍然存在。结论 GERD 患者经埃索美拉唑治疗2个月后 DIS 恢复正常伴随症状消失,各组间在 DIS 恢复上差异无统计学意义。
Objective To observe the changes of DIS in the esophageal mucosa epithelial cells before and after esomeprazole treatment in patients with gastroesophageal reflux disease (GERD) subtypes. Methods Nineteen patients were treated with heartburn and were treated with esomeprazole 40 mg / d for 2 months after endoscopy, 24h esophageal pH monitoring and proton pump inhibitor therapy. Before and after the endoscopic examination in the esophageal dentate line 3 ~ 5 cm at the appearance of normal mucosa biopsy, respectively, histological and transmission electron microscopy. 15 cases of normal esophageal mucosa biopsy as a normal parameter. Results Erectile esophagitis (6 cases), NERD (7 cases) with pathologic acid reflux, and NERD (6 cases) without pathological acid reflux were recovered after 2 months Cases (83.33%), 6 cases (85.71%) and 5 cases (83.33%) all disappeared with heartburn symptoms. Two of the three patients with DIS that did not return to normal still had heartburn symptoms. Conclusions After 2 months of esomeprazole treatment in GERD patients, DIS returned to normal with the disappearance of symptoms. There was no significant difference in DIS recovery between groups.