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胃食管反流病患者的复发情况及其对健康相关生活质量的影响:一项前瞻性随访分析

Recurrence and Its Impact on the Health-related Quality of Life in Patients with Gastroesophageal Reflux Disease: A Prospective Follow-up Analysis.

作者信息

Min Yang Won, Shin Yong Woon, Cheon Gab Jin, Park Kyung Sik, Kim Hyun Soo, Sohn Chong-Il, Kim Tae Nyeun, Moon Hyeung Cheol, Rhee Poong-Lyul

机构信息

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.

出版信息

J Neurogastroenterol Motil. 2016 Jan 31;22(1):86-93. doi: 10.5056/jnm15124.

Abstract

BACKGROUND/AIMS: Limited data exist on the outcome of gastroesophageal reflux disease (GERD) treatment and its impact on the health-related quality of life (HRQoL) in the Asian population. This study aims to evaluate the treatment outcomes, to investigate the factors associated with recurrence, and to evaluate the impact of the treatment outcome on the HRQoL in a Korean GERD population.

METHODS

This was a prospective, multicenter study involving a total of 824 GERD patients. The response to treatment was assessed at week 4 (or week 8 for the patients who did not achieve complete resolution [CR] at week 4). The EQ-5D questionnaire was used at baseline, end of treatment, and first recurrence to assess the HRQoL. To assess GERD symptoms, contact of patients by phone at 1, 6, and 12 months following treatment was carried out.

RESULTS

CR was achieved in 65.6% and recurrence was observed in 47.8% following treatment. CR and recurrence rates did not differ by the presence of esophagitis. Multivariate analysis revealed that acid regurgitation (odds ratio 2.249; 95% confidence interval 1.293-3.912; P= 0.004) and both acid regurgitation and heartburn (odds ratio 2.330; 95% confidence interval 1.392-3.901; P= 0.001) were independent risk factors for GERD recurrence. EQ-5D scores were more improved in patients with CR than in those without CR, and worsened more during follow-up in patients with recurrence than in those without recurrence.

CONCLUSIONS

We should achieve complete symptom relief and attempt to prevent recurrence in GERD patients to improve their HRQoL.

摘要

背景/目的:关于亚洲人群胃食管反流病(GERD)治疗结果及其对健康相关生活质量(HRQoL)影响的数据有限。本研究旨在评估韩国GERD患者的治疗结果,调查与复发相关的因素,并评估治疗结果对HRQoL的影响。

方法

这是一项前瞻性、多中心研究,共纳入824例GERD患者。在第4周(对于第4周未实现完全缓解[CR]的患者则在第8周)评估治疗反应。在基线、治疗结束时和首次复发时使用EQ-5D问卷评估HRQoL。为评估GERD症状,在治疗后1、6和12个月通过电话联系患者。

结果

治疗后CR率为65.6%,复发率为47.8%。食管炎的存在与否对CR率和复发率无影响。多因素分析显示,反酸(比值比2.249;95%置信区间1.293 - 3.912;P = 0.004)以及反酸和烧心同时存在(比值比2.330;95%置信区间1.392 - 3.901;P = 0.001)是GERD复发的独立危险因素。有CR的患者EQ-5D评分改善程度高于无CR的患者,复发患者在随访期间的评分恶化程度高于未复发患者。

结论

我们应实现GERD患者症状的完全缓解,并尝试预防复发,以改善他们的HRQoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba1b/4699725/b0a15d7c0244/jnm-22-086f1.jpg

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