作者：蔡仁颂 ，杨维忠，崔光锐，温必盛

单位：海南医学院第二附属医院 消化内镜科， 海南 海口 570311

Authors: Cai Rensong，Yang Weizhong，Cui Guangrui，Wen Bisheng

Unit: Department of Gastrointestinal Endoscopy, Second Affiliated Hospital of Hainan Medical College, Haikou 570311, Hainan, China

摘要：

目的 观察食管反流病患者使用质子泵抑制剂与胃癌发生风险的相关性。方法 选取海南医学院第二附属医院消化科2020年9月至2021年9月收治的胃食管反流病患者100例，用随机数字表法将其分为研究组和对照组，每组各50例。两组患者研究开始前均实行C13呼气试验评估幽门螺杆菌感染情况、胃镜检查以及病理活检排除胃癌可能，研究组患者口服质子泵抑制剂治疗，对照组患者进行生活习惯。宣教两组患者在试验后9、18、24个月分别实行C13呼吸试验、胃镜检查以及病理活检。结果 研究组0、9、18、24个月幽门螺杆菌阳性感染率与对照组对比，差异无统计学意义(P>0.05)。研究组9、18、24个月的萎缩性胃炎、肠上皮化生和上皮内瘤变发生率均高于对照组(P<0.05)。结论 长期使用质子泵抑制剂会增加胃食管反流病患者胃癌的发生风险。

关键词：胃食管反流病；质子泵抑制；胃癌；风险

Abstract：

Objective To observe the correlation between the use of proton pump inhibitors and the risk of gastric cancer in patients with esophageal reflux disease. Method 100 patients with gastroesophageal reflux disease treated in our hospital from September 2020 to September 2021 were selected as the research object. They were divided into the study group and the control group with 50 cases in each group by random number analysis table. Before the experiment, carbon breath test, gastroscopy and pathological biopsy were performed in both groups. The patients in the study group were treated with oral proton pump inhibitors, and the patients in the control group did not take any intervention treatment. Carbon breath test, gastroscopy and pathological biopsy were performed in the two groups 9, 18 and 24 months after the test. Result There was no significant difference in the positive infection rate of Helicobacter pylori between the study group and the control group at 0, 9, 18 and 24 months （P>0.05）. The incidence of atrophic gastritis, intestinal metaplasia and intraepithelial neoplasia in the study group at 9, 18 and 24 months were lower than those in the control group （P<0.05）. Conclusion Long term use of proton pump inhibitors can reduce the risk of gastric cancer in patients with gastroesophageal reflux disease.

Key Words: Gastroesophageal reflux disease；Proton pump inhibitor；Gastric cancer；Risk