ABSTRACT
Objective To analyze and explore the clinical value of CYP2C19 genetic polymorphism in the treatment of refractory gastroesophageal reflux disease.Methods The CYP2C19 genetic polymorphism was detected and analyzed in 198 RGERD patients.According to genotyping,the patients were divided into extensive metabolism and poor metabolism.Each patient was filled in RDQ and LA Classification(from A to D) by endoscopy before and after 8 weeks of PPI treatment.Results There were 160 cases in EM group,mean age 53.23-± 14.52 years old.There were 38 cases in PM group,mean age 52.11 ± 12.13 years old.And all patients were treated with omeprazole 20 mg (twice daily).The mean score of RDQ in the PM group was significantly decreased after 8 weeks,and the esophageal mucosal lesion was significantly improved by endoscopy(P ＜ 0.05),but there was no significant difference in EM group with RDQ and LA (P ＞ 0.05).Conclusion The RGERD patients with poor metabolism group of CYP2C19 using proton pump inhibitors can achieve better efficacy.Theoretically,increasing the PPI dose can achieve the desired effect in the patients of EM group.So the clinician can be based on metabolic typing to achieve individualized medication and rationalization of medication.