Kulig M, Leodolter A, Vieth M, Schulte E, Jaspersen D, Labenz J, Lind T, Meyer-Sabellek W, Malfertheiner P, Stolte M, Willich S N
Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.
Aliment Pharmacol Ther. 2003 Oct 15;18(8):767-76. doi: 10.1046/j.1365-2036.2003.01770.x.
To determine the impact of gastro-oesophageal reflux disease (GERD) on the quality of life, to assess changes in the quality of life during treatment with esomeprazole and to define factors that can predict these changes.
Patients with GERD (n=6215) were included in a prospective cohort study (ProGERD). All patients underwent endoscopy and received esomeprazole. At baseline and after 2 weeks of treatment, symptoms and quality of life were assessed. Factors that influenced changes in the quality of life were determined by multiple regression analyses.
At baseline, the quality of life in GERD patients was lower than that in the general population, and was similar to that in patients after acute coronary events. No differences in symptoms or quality of life were observed between the subgroups of patients with non-erosive GERD, erosive GERD and Barrett's oesophagus. After treatment with esomeprazole, the symptoms and quality of life were improved in all subscales within 2 weeks (P<0.001). The mean score of the disease-specific quality of life instrument (Quality of Life in Reflux and Dyspepsia Patients) increased from 4.6 to 6.2 points, representing a highly relevant clinical improvement. The generic quality of life (SF-36) reached levels similar to those in the general population, but, again, no difference was found between the three different subgroups of GERD patients. The main factors associated with an improvement in the quality of life after treatment were symptom relief, severe erosive reflux disease, absence of extra-oesophageal disorders, avoidance of non-steroidal anti-inflammatory drug intake and positive Helicobacter pylori status.
GERD causes a significant impairment in the quality of life that can be attenuated or normalized within a time period as short as 2 weeks by treatment with esomeprazole. These findings were similar across the whole GERD patient spectrum.
确定胃食管反流病（GERD）对生活质量的影响，评估埃索美拉唑治疗期间生活质量的变化，并确定可预测这些变化的因素。
GERD患者（n = 6215）纳入前瞻性队列研究（ProGERD）。所有患者均接受内镜检查并服用埃索美拉唑。在基线和治疗2周后，评估症状和生活质量。通过多元回归分析确定影响生活质量变化的因素。
基线时，GERD患者的生活质量低于普通人群，与急性冠状动脉事件后的患者相似。非糜烂性GERD、糜烂性GERD和巴雷特食管患者亚组之间在症状或生活质量方面未观察到差异。使用埃索美拉唑治疗后，所有亚量表的症状和生活质量在2周内均得到改善（P<0.001）。疾病特异性生活质量量表（反流和消化不良患者生活质量）的平均得分从4.6分提高到6.2分，代表了高度相关的临床改善。一般生活质量（SF-36）达到与普通人群相似的水平，但同样，GERD患者的三个不同亚组之间未发现差异。治疗后生活质量改善的主要相关因素是症状缓解、严重糜烂性反流病、无食管外疾病、避免服用非甾体抗炎药和幽门螺杆菌阳性状态。
GERD会导致生活质量显著受损，通过埃索美拉唑治疗可在短短2周内减轻或恢复正常。这些发现适用于整个GERD患者群体。
