科研之友
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摘要
Background: The proton-pump inhibitor (PPI) test has been proposed as a valuable tool for diagnosing gastroesophageal reflux disease in Western population. Goals: We aim to compare the diagnostic accuracy of the PPI test Using rabeprazole and pantoprazole in it Chinese population with it higher prevalence of poor PPI metabolization. Study: After diagnostic endoscopy, patients with gastroesophageal reflux disease symptoms were randomly assigned to it 2-week test with rabeprazole (20 mg b.i.d.) or pantoprazole (40mg b.i.d.). Therapeutic response was assessed with it 5-grade daily record. Genotypes of cytochrome 13450 (CYP) 2C19 polymorphism were determined. Results: Of the 178 patients who completed the study, 92 (51.7%) had erosive esophagitis and 78 (48.3%) were endoscopy-negative reflux disease. On the basis of 50% reduction of symptoms, there was it nonsignificant difference of diagnostic performances between rabeprazole and pantoprazole. For the CYP2C19 genotypes, 138 (87.3%,) were determined to be extensive metabolizers (EMs) and 20 (12.7%) were poor metabolizers (PMs). When comparing the EMs and PMs. the diagnostic specificity in the prediction of erosive esophagitis was higher in the EMs (57.6% vs. 20.0%, P = 0.040). as was the accuracy (74.6% vs. 50.0%, P = 0.023) There were no differences in the sensitivity, positive predictive value. or negative predictive value. Conclusions: CYP2C19 genotypic polymorphism was related to it higher possibility of false-positive results for patients who metabolized PPI poorly. High-dose rabeprazole and pantoprazole showed,I similar diagnostic performance.
- 出版日期2009-12
