Cyclic vomiting syndrome in 28 patients: demographics, features and outcomes
Cyclic vomiting syndrome in 28 patients: demographics, features and outcomes
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28 例患者的周期性呕吐综合征：人口统计、特征和结果
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发表时间：
2012
期刊：
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通讯作者：
S. Anderson
中科院分区：
文献类型：
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作者：
L. Lee;L. Abbott;S. Moodie;S. Anderson
简介 周期性呕吐综合征 (CVS) 是一种以反复发作、刻板的强烈恶心和顽固性呕吐为特征的疾病，且原因不明。根据罗马Ⅲ标准诊断；然而，这种情况仍然是一组异质的症状，很少有研究详细分析患者报告的特征。三环类抗抑郁药可能会使一些患者受益，但没有关于这种情况的长期结果的数据。方法 这是一项回顾性队列研究，研究对象为 1994 年至 2011 年间在伦敦两家教学医院接受治疗的所有患者。通过住院病例记录、诊所信函和使用标准化调查问卷的电话访谈来获取信息。结果 确定了 28 名患者，其中 17 名患有成人发病的 CVS，11 名患有儿童发病的 CVS。在成人发病的 CVS 队列中，平均发病年龄为 30 岁；头痛的患病率为 57.1%，焦虑/抑郁的患病率为 21.7%。呕吐发作平均每年发生10次，平均持续时间为55.3小时。在儿童期发病的 CVS 队列中，平均发病年龄为 5 岁，头痛患病率为 44.4%。呕吐发作平均每年发生25.5次，平均持续时间为54.5小时。在急性发作期间，患者认为基于吗啡的药物最有效。总体而言，65.4% 的患者未接受长期预防性药物治疗，其中 42.1% 认为症状有所改善，26.3% 报告完全缓解。结论 CVS 是一种使人衰弱的疾病，发作频繁且持续时间长。与焦虑/抑郁以及头痛有很高的关联。抗偏头痛药物、β-受体阻滞剂和抗癫痫治疗可能会成功减轻发作；然而，在这项长期研究中，未接受这些药物治疗的患者的预后也很好。总体而言，平均 7 年后，61.9% 的患者症状逐渐改善，23.8% 的患者症状完全缓解。
Introduction Cyclic vomiting syndrome (CVS) is a condition characterized by recurrent, stereotyped, attacks of intense nausea and intractable vomiting with no identifiable cause. The diagnosis is made according to the Rome III criteria; however, the condition remains a heterogenous group of symptoms and few studies have analysed patient-reported features in detail. Tricyclic antidepressants may benefit some patients, but there are no data on the long-term outcomes of this condition. Methods This is a retrospective cohort study of all patients treated at two London teaching hospitals between 1994 and 2011. Information was obtained by means of inpatient case notes, clinic letters and telephone interviews using a standardized questionnaire. Results Twenty-eight patients were identified, 17 with adult-onset CVS and 11 with childhood-onset CVS. In the adult-onset CVS cohort, the average age of onset was 30 years; the prevalence of headache was 57.1% and anxiety/depression 21.7%. Vomiting attacks occurred on average 10 times a year with a mean duration of 55.3 h. In the childhood-onset CVS cohort, the average age of onset was 5 years and the prevalence of headaches was 44.4%. Vomiting attacks occurred on average 25.5 times a year with a mean duration of 54.5 h. During acute attacks, patients rated morphine-based medications as the most efficacious. Overall, 65.4% of our patients were not treated with long-term prophylactic medications and, of these, 42.1% felt that their symptoms had improved and 26.3% reported complete resolution. Conclusion CVS is a debilitating illness with frequent attacks of prolonged duration. There is a high association with anxiety/depression as well as headaches. Antimigraine medication, &bgr;-blockers and antiepileptic treatment may be successful at attenuating attacks; however, in this long-term study, the prognosis of patients not treated with these medications was also good. Overall, 61.9% of patients showed a gradual improvement in symptoms and 23.8% had complete resolution after a mean of 7 years.