Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms
Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms
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胃食管反流病和质子泵抑制剂难治性症状的患病率
DOI：
10.1053/j.gastro.2019.12.014
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发表时间：
2020-04-01
期刊：
影响因子：
29.4
通讯作者：
Spiegel, Brennan M. R.
中科院分区：
文献类型：
--
作者：
Delshad, Sean D.;Almario, Christopher V.;Spiegel, Brennan M. R.
背景与目的：关于美国胃食管反流病（GERD）患病率的数据很少。我们进行了一项基于人群的研究，以确定 GERD 症状的患病率以及尽管使用质子泵抑制剂 (PPI) 仍持续出现 GERD 症状。方法：我们在 2015 年使用 MyGiHealth 进行了全国胃肠道调查，该应用程序指导参与者完成美国国立卫生研究院胃肠道患者报告结果测量信息系统调查。主要结局是服用 PPI 的参与者过去 GERD 症状的患病率以及 GERD 症状的持续性（过去一周 2 天或以上胃灼热或反流）。将总体权重应用于数据，并使用多变量回归来调整混杂因素。结果：在 71,812 名参与者中，32,878 人（44.1%）报告过去曾出现过 GERD 症状，23,039 人（30.9%）报告在过去一周出现过 GERD 症状。我们还发现，有 GERD 症状的人中有 35.1% 目前正在接受治疗（55.2% 正在接受 PPI 治疗，24.3% 正在接受组胺 2 受体阻滞剂治疗，24.4% 正在接受抗酸剂治疗）。在 3229 名每日服用 PPI 的参与者中，54.1% 的人有持续性胃食管反流病症状。年轻的个体、女性、拉丁裔个体以及患有肠易激综合征或克罗恩病的参与者更有可能出现持续症状，即使在服用 PPI 时也是如此。结论：通过基于人群的调查，我们发现 GERD 症状很常见：5 名参与者中有 2 人过去曾出现过 GERD 症状，3 人中有 1 人在过去一周出现过症状。我们还发现一半的 PPI 使用者有持续的症状。鉴于 GERD 对生活质量的显着影响，针对 PPI 难治性 GERD 症状的患者需要进一步研究和开发新疗法。
BACKGROUND & AIMS: There are few data on the prevalence of gastroesophageal reflux disease (GERD) in the United States. We performed a population-based study to determine the prevalence of GERD symptoms and persistent GERD symptoms despite use of proton pump inhibitors (PPIs). METHODS: We conducted the National Gastrointestinal Survey in 2015 using MyGiHealth, an app that guides participants through National Institutes of Health gastrointestinal Patient-Reported Outcomes Measurement Information System surveys. Primary outcomes were prevalence of GERD symptoms in the past and persistence of GERD symptoms (heartburn or regurgitation 2 or more days in past week) among participants taking PPIs. Population weights were applied to the data and multivariable regression was used to adjust for confounding. RESULTS: Among 71,812 participants, 32,878 (44.1%) reported having had GERD symptoms in the past and 23,039 (30.9%) reported having GERD symptoms in the past week. We also found that 35.1% of those who had experienced GERD symptoms were currently on therapy (55.2% on PPIs, 24.3% on histamine-2 receptor blockers, and 24.4% on antacids). Among 3229 participants taking daily PPIs, 54.1% had persistent GERD symptoms. Younger individuals, women, Latino individuals, and participants with irritable bowel syndrome or Crohn's disease were more likely to have continued symptoms, even when taking PPIs. CONCLUSIONS: Using a population-based survey, we found GERD symptoms to be common: 2 of 5 participants have had GERD symptoms in the past and 1 of 3 had symptoms in the past week. We also found that half of PPI users have persistent symptoms. Given the significant effect of GERD on quality of life, further research and development of new therapies are needed for patients with PPI-refractory GERD symptoms.