Predictive factors of response to proton pump inhibitors in korean patients with gastroesophageal reflux disease.
Predictive factors of response to proton pump inhibitors in korean patients with gastroesophageal reflux disease.
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DOI：
10.5056/jnm14078
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发表时间：
2015-01-01
影响因子：
3.4
通讯作者：
Jung HC
中科院分区：
文献类型：
--
作者：
Kim SE;Kim N;Oh S;Kim HM;Park MI;Lee DH;Jung HC
质子泵抑制剂（PPIs）广泛应用于胃食管反流病（GERD）的治疗。然而，一些患者对PPI治疗没有反应。我们研究了胃食管反流症状患者对PPI治疗的疗效。前瞻性纳入179名有GERD症状的受试者，并通过胃镜检查、Bernstein试验和/或24小时食管pH试验诊断为非糜烂性反流病（NERD, n = 100）和糜烂性反流病（n = 79）。然后受试者接受标准剂量的每日PPI治疗至少4周。采用人口统计学、胃食管反流症状、胃食管反流影响量表、Epworth嗜睡量表、匹兹堡睡眠质量指数（PSQI）、医院焦虑抑郁量表和世界卫生组织生活质量简易量表等问卷评估PPI治疗效果。179例患者的完全缓解率（≥80%）、满意缓解率（≥50%）、部分缓解率（< 50%）和难治缓解率分别为41.3%、30.2%、18.4%和10.1%。因此，总体反应率（完整和满意的反应）为71.5%。多因素分析显示，体重指数< 23 kg/m2 （OR, 2.20; 95% CI, 1.12-4.34）、PSQI总分较高（OR, 1.20; 95% CI, 1.05-1.35）、心理治疗或神经精神药物史（OR, 2.44; 95% CI, 1.23-4.85）和NERD （OR, 3.30; 95% CI, 1.54-7.11）与PPI治疗反应较差相关。心理因素、睡眠障碍、体重指数< 23 kg/m2和NERD似乎是导致胃食管反流症状患者对PPI治疗反应不佳的主要因素。
Proton pump inhibitors (PPIs) are widely used in the treatment of gastroesophageal reflux disease (GERD). However, some patients fail to respond to PPI therapy. We investigated the efficacy of response to PPI therapy in patients with GERD symptoms. A total of 179 subjects with GERD symptoms were prospectively enrolled and diagnosed with non-erosive reflux disease (NERD, n = 100) and erosive reflux disease (n = 79) by gastroscopy and Bernstein test and/or 24-hour esophageal pH testing. Subjects then received a standard dose of daily PPI therapy for at least 4 weeks. PPI therapy response was evaluated using questionnaires including questions about demographics, GERD symptoms, GERD impact scale, Epworth sleepiness scale, Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale, and abbreviated version of the World Health Organization quality of life scale. The rates of complete (≥ 80%), satisfactory (≥ 50%), partial (< 50%), and refractory response in the 179 participants were 41.3%, 30.2%, 18.4%, and 10.1%, respectively. Thus, overall response rate (complete and satisfactory responses) was 71.5%. Multivariate analysis showed body mass index < 23 kg/m2 (OR, 2.20; 95% CI, 1.12–4.34), higher total PSQI score (OR, 1.20; 95% CI, 1.05–1.35), history of psychotherapy or neuropsychiatric medication (OR, 2.44; 95% CI, 1.23–4.85), and NERD (OR, 3.30; 95% CI, 1.54–7.11) were associated with poor response to PPI therapy. Psychological factors, sleep dysfunction, body mass index < 23 kg/m2, and NERD seem to be the major factors that lead to a poor response to PPI treatment in patients with GERD symptoms.
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影响因子：
3.5
作者：
Bredenoord AJ;Fox M;Kahrilas PJ;Pandolfino JE;Schwizer W;Smout AJ;International High Resolution Manometry Working Group
通讯作者：
International High Resolution Manometry Working Group
影响因子：
3.4
作者：
Kim JY;Kim N;Seo PJ;Lee JW;Kim MS;Kim SE;Jo SY;Lee DH;Jung HC
通讯作者：
Jung HC
影响因子：
29.4
作者：
Fass, Ronnie;Naliboff, Bruce D.;Mayer, Emeran A.
通讯作者：
Mayer, Emeran A.
影响因子：
4.7
作者：
Ju, Gawon;Yoon, In-Young;Kim, Nayoung
通讯作者：
Kim, Nayoung
影响因子：
3.4
作者：
Jo, So Young;Kim, Nayoung;Jung, Hyun Chae
通讯作者：
Jung, Hyun Chae