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中国临床药理学与治疗学 ›› 2022, Vol. 27 ›› Issue (10): 1190-1196.doi: 10.12092/j.issn.1009-2501.2022.10.014

• 综述与讲座 • 上一篇    下一篇

钾离子竞争性酸阻断剂在反流性食管炎中的治疗进展

杨梦娇1,2,3,袁 浩2,3,郑 亚2,3,王玉平2,3,郭庆红2,3   

  1. 1兰州大学第一临床医学院,2兰州大学第一医院消化科,3甘肃省胃肠病重点实验室,兰州 730000,甘肃
  • 收稿日期:2022-06-06 修回日期:2022-10-27 出版日期:2022-10-27 发布日期:2022-11-14
  • 通讯作者: 郭庆红,女,博士,主任医师,硕士生导师,研究方向:消化系统疾病诊疗。 E-mail: gqh@lzu.edu.cn
  • 作者简介:杨梦娇,女,硕士,研究方向:消化系统疾病诊疗。 E-mail: 1165126043@qq.com
  • 基金资助:
    甘肃省自然科学基金(21JR1RA117,20JR5RA347);兰州大学第一医院院内基金(ldyyyn2019-28,ldyyyn2018-54)

Advances in the treatment of potassium-competitive acid blockers in reflux esophagitis

YANG Mengjiao1,2,3, YUAN Hao2,3, ZHENG Ya2,3, WANG Yuping2,3, GUO Qinghong2,3   

  1. 1 Lanzhou University, First Clinical Medical College; 2 The First Hospital of Lanzhou University, Department of Gastroenterology; 3 Gansu Provincial Key Laboratory of Gastroenterology, Lanzhou 730000, Gansu,China
  • Received:2022-06-06 Revised:2022-10-27 Online:2022-10-27 Published:2022-11-14

摘要: 反流性食管炎(reflux esophagitis, RE)是一种由多种损伤因素所致的以食管下括约肌障碍为主的胃食管动力障碍性疾病,临床上多使用质子泵抑制剂(proton pump inhibitors, PPIs)等抑酸药物治疗,但随着耐质子泵抑制剂型反流性食管炎病例的增多,对抑酸药的药代动力学及药效学表现出更高的需求。近年来一类新型的抑酸药物钾离子竞争性酸阻断剂(potassium-competitive acid blockers, P-CABs)的出现解决了传统的质子泵抑制剂在临床上的一些不足,表现出首剂全效、更持久的抑酸作用、对胃酸分泌的抑制作用不受胃酸分泌状态的影响、药物代谢和功效的个体差异更小、给药疗效不受是否摄食的影响等特点,对糜烂性食管炎及耐PPIs的严重糜烂性食管炎的疗效都有明显的优势,同时更具有成本效益,有望取代PPIs成为反流性食管炎的一线治疗方案。

关键词: 反流性食管炎, 钾离子竞争性酸阻断剂, 作用机制, 临床反应, 不良反应

Abstract: Reflux Esophagitis (RE) is a gastroesophageal motility disorder mainly caused by lower esophageal sphincter disorder caused by a variety of injury factors, acid-suppressing drugs such as Proton Pump Inhibitors (PPIs) are often used clinically. With the increase of PPIs-resistant reflux esophagitis cases, the demand for the pharmacokinetics and pharmacodynamics of acid-suppressing drugs is higher. In recent years, the emergence of a new class of acid-suppressing drugs, potassium-competitive acid blockers (P-CABs), has solved some clinical deficiencies of traditional proton pump inhibitors. It has the characteristics of effective, longer-lasting acid suppression, the inhibitory effect on gastric acid secretion is not affected by the state of gastric acid secretion, the individual differences in drug metabolism and efficacy are smaller, and the drug efficacy is not affected by food intake or not. It has obvious advantages in the efficacy of severe erosive esophagitis and PPIs-resistant severe erosive esophagitis, and is more cost-effective, and is expected to replace PPI as the first-line treatment for reflux esophagitis.    

Key words: reflux esophagitis, potassium-competitive acid blockers, mechanism of action, clinical efficacy, adverse reaction

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