摘要:
Portal hypertensive gastropathy (PHG) has a high incidence rate in cirrhotic patients,leading to a high risk of upper gastrointestinal bleeding.Gastric mucosal injury is the major pathological change of PHG.There are few studies focusing on the clinical application of antacids in the treatment of PHG in cirrhotic patients and there are still controversies over this issue.This article reviews the influencing factors for PHG,the mechanism of gastric mucosal injury,and the application of antacids.It is pointed out that during the treatment of PHG,besides the reduction in portal venous pressure,the application of antacids such as proton pump inhibitors can improve the cure rate of PHG.Prospective randomized control trials with a large sample size are needed to further demonstrate the clinical effect and safety of antacids in the treatment of PHG in cirrhotic patients.%肝硬化門(mén)靜脈高壓性胃病(PHG)的發(fā)病率高,并發(fā)上消化道出血的風(fēng)險(xiǎn)大.胃黏膜損傷是其主要的病理改變,抗酸劑在肝硬化PHG中的應(yīng)用研究較少且存在爭(zhēng)議.對(duì)PHG的影響因素、胃黏膜損傷機(jī)制及抗酸劑的應(yīng)用進(jìn)行了概括.認(rèn)為治療PHG過(guò)程中,在降低門(mén)靜脈壓力的同時(shí)使用質(zhì)子泵抑制劑等抑酸藥物可提高PHG的治愈率.但不同抑酸藥物干預(yù)肝硬化PHG的療效及安全性進(jìn)行客觀評(píng)價(jià)仍需通過(guò)前瞻性、大樣本、隨機(jī)對(duì)照試驗(yàn)進(jìn)一步證實(shí).
摘要:
嘉胃斯康是典型治療胃食管返流病的海藻酸鈉制劑.它在胃酸中可以形成一種漂浮的凝膠筏,較好地阻止胃食管返流.我們?cè)u(píng)價(jià)這個(gè)體系的指標(biāo)有多種參數(shù),如強(qiáng)度、體積、漂浮性、耐受力和彈性.另外,凝膠筏的強(qiáng)度還受許多因素影響,如分子量、M/G的比值.這兩種參數(shù)是影響筏強(qiáng)度大小的內(nèi)在因素.一些外在的因素如筏中鈣離子的存在,包裹在筏中的二氧化碳數(shù)量.本文主要總結(jié)了如何評(píng)價(jià)凝膠筏,介紹了影響凝膠筏的因素,最后概括了海藻酸鈉的降解情況及未來(lái)的進(jìn)展.%Formulations of Gaviscon based on novel alginate raft forming system have been developed to prevent gastroesophageal reflux disease (GERD) symptoms.Alginate gel becomes buoyant and CO2-aerated as soon as Gaviscon comes into contact with gastric contents.This system can be characterized by several indicators,such as strength or coherence,volume,buoyancy,reflux resistance and resilience.In addition,the strength of the raft is influenced by many factors,such as molecular weight and the ratio of D-mannuronic and L-guluronic acid residues (M/G),which are intrinsic factors in this formulation.Besides,there are several extrinsic factors,such as the presence of specific cations,the amount of carbon dioxide generated and entrapped in the raft.This review focused on how to evaluate the raft,introduced some factors that impact the raft and summarized the degradation of alginate and future advance.