Predictors of clinical response of acid suppression in Chinese patients with gastroesophageal reflux disease
Predictors of clinical response of acid suppression in Chinese patients with gastroesophageal reflux disease
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DOI：
10.1016/j.dld.2012.11.017
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发表时间：
2013-04-01
影响因子：
4.5
通讯作者：
Zhu, Xuan
中科院分区：
文献类型：
--
作者：
Wang, An Jiang;Wang, He;Zhu, Xuan
背景：高达40%的胃食管反流病患者对质子泵抑制剂治疗无效。目的：探讨质子泵抑制剂治疗临床疗效的预测因素。方法：前瞻性纳入连续胃食管反流病患者。所有患者均行上腔镜检查和24小时多通道腔内阻抗和pH监测，然后给予埃索美拉唑20mg / d，连续2个月。多因素logistic回归分析用于确定质子泵抑制剂治疗临床反应的独立预测因素。结果：共招募和筛选了204例有典型反流症状的患者。153例患者（平均年龄46.3±10.6岁，51.0%为女性）完成所有检查并给予质子泵抑制剂治疗。95例患者（62.1%）在2个月后对抑酸有反应。多因素logistic分析显示，病理性远端食管酸反流是反应的预测因子（P = 0.001）。与质子泵抑制剂治疗失败相关的因素是肠易激综合征单独存在（P = 0.006），抑郁（P = 0.005），肠易激综合征和功能性消化不良重叠（P = 0.002）。结论：抑酸治疗胃食管反流病的临床疗效可通过临床及pH参数预测，而非阻抗数据。(c) 2012年Editrice gastroenteritaliana S.r.l, Elsevier Ltd.出版版权所有。
Background: Up to 40% of patients with gastroesophageal reflux disease fail to respond to proton pump inhibitor therapy.Aims: To determine predictors of clinical response of proton pump inhibitor therapy.Methods: Consecutive patients with gastroesophageal reflux disease were enrolled prospectively. All patients underwent upper endoscopy and 24-h multichannel intraluminal impedance and pH monitoring before receiving esomeprazole 20 mg b.i.d. for 2 months. Multivariate logistic regression analysis was used to determine the independent predictors of clinical response to proton pump inhibitor therapy.Results: A total of 204 patients with typical reflux symptoms were recruited and screened. Among them 153 patients (mean age 46.3 +/- 10.6 years, 51.0% female) completed all the examinations and were assigned to proton pump inhibitor therapy. Ninety-five patients (62.1%) responded to acid suppression after 2 months. Multivariate logistic analysis showed that the predictor for response was pathological distal esophageal acid reflux (P = 0.001). The factors associated with proton pump inhibitor therapy failure were the presence of irritable bowel syndrome alone (P = 0.006), depression (P = 0.005), and overlap of irritable bowel syndrome and functional dyspepsia (P = 0.002).Conclusions: The clinical response of acid suppression on gastroesophageal reflux disease could be predicted by clinical and pH parameters rather than impedance data. (c) 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.