Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 703 19th Street South, Birmingham, AL 35294-0007, USA.
Dig Dis Sci. 2010 Nov;55(11):3108-12. doi: 10.1007/s10620-010-1391-2. Epub 2010 Sep 8.
Zollinger-Ellison syndrome (ZES) is associated with complicated ulcer disease of the upper gastrointestinal tract. While management of ZES has dramatically improved with proton pump inhibitor therapy, quality of life in medically treated patients has not been evaluated.
Over a 3-year period, 52 patients with ZES were prospectively evaluated at 6-month intervals with upper endoscopy and gastric acid analysis to evaluate the efficacy of current drug therapy and completion of SF36v2 forms. At each 6-month visit, patients' medication and problem lists were reviewed, comorbidities assessed, and any gastrointestinal symptoms recorded. Co-morbidity was represented as a simple illness count for the main analysis. The chronic disease score and the Charlson index were used for sensitivity analyses.
The unadjusted norm-based estimate of mental component score (MCS) for 52 patients with ZES (mean age 58, 65% male) was 49.8 (95% CI 46.4, 53.1). The unadjusted estimate of the physical component score (PCS) was 42.3 (95% CI 38.9, 45.7). As the number of illnesses or number of medications increased, there was a monotonic decrease in PCS scores. With multivariable adjustment, the coefficient for number of medications became non-significant. An increase in each of the co-morbidity indexes was associated with a decrease in PCS. Results did not vary by representation of co-morbidity. MCS was not significantly different from the general population.
Patients with medically managed ZES have norm-based estimates of the mental component scores as measured by the SF-36v2 that approximate normal values, while the physical component scores were decreased with this reduction largely explained by co-morbid illness.
卓-艾综合征（ZES）与上消化道复杂的溃疡性疾病有关。虽然质子泵抑制剂治疗极大地改善了 ZES 的治疗效果，但接受药物治疗的患者的生活质量尚未得到评估。
在 3 年期间，对 52 例 ZES 患者进行前瞻性评估，每 6 个月进行一次上消化道内镜检查和胃酸分析，以评估当前药物治疗的疗效，并完成 SF36v2 表格。在每次 6 个月的就诊中，回顾患者的药物和问题清单，评估合并症，并记录任何胃肠道症状。共病用主要分析中的简单疾病计数表示。慢性病评分和 Charlson 指数用于敏感性分析。
未经调整的 ZES 患者（平均年龄 58 岁，65%为男性）的基于标准的心理成分评分（MCS）的未调整标准均数估计值为 49.8（95%CI 46.4，53.1）。未经调整的生理成分评分（PCS）估计值为 42.3（95%CI 38.9，45.7）。随着疾病数量或药物数量的增加，PCS 评分呈单调下降。经过多变量调整，药物数量的系数变得不显著。每增加一种合并症指数，PCS 都会降低。结果不因共病表示方式而异。MCS 与一般人群无显著差异。
接受药物治疗的 ZES 患者的 SF-36v2 心理健康成分评分的标准均数估计值与正常人群相近，而生理成分评分则降低，这种降低主要与合并症有关。
