López-Colombo A, Pacio-Quiterio M S, Jesús-Mejenes L Y, Rodríguez-Aguilar J E G, López-Guevara M, Montiel-Jarquín A J, López-Alvarenga J C, Morales-Hernández E R, Ortiz-Juárez V R, Ávila-Jiménez L
Dirección de Educación e Investigación, UMAE Hospital de Especialidades CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México.
Unidad de Medicina Familiar Número 1, Instituto Mexicano del Seguro Social, Puebla, México.
Rev Gastroenterol Mex. 2017 Apr-Jun;82(2):106-114. doi: 10.1016/j.rgmx.2016.09.001. Epub 2017 Mar 7.
There are no studies on the factors associated with gastroesophageal reflux disease (GERD) relapse in primary care patients.
To identify the risk factors associated with GERD relapse in primary care patients that responded adequately to short-term treatment with a proton pump inhibitor.
A cohort study was conducted that included GERD incident cases. The patients received treatment with omeprazole for 4 weeks. The ReQuest questionnaire and a risk factor questionnaire were applied. The therapeutic success rate and relapse rate were determined at 4 and 12 weeks after treatment suspension. A logistic regression analysis of the possible risk factors for GERD relapse was carried out.
Of the 83 patient total, 74 (89.16%) responded to treatment. Symptoms recurred in 36 patients (48.64%) at 4 weeks and in 13 patients (17.57%) at 12 weeks, with an overall relapse rate of 66.21%. The OR multivariate analysis (95% CI) showed the increases in the possibility of GERD relapse for the following factors at 12 weeks after treatment suspension: basic educational level or lower, 24.95 (1.92-323.79); overweight, 1.76 (0.22-13.64); obesity, 0.25 (0.01-3.46); smoking, 0.51 (0.06-3.88); and the consumption of 4-12 cups of coffee per month, 1.00 (0.12-7.84); citrus fruits, 14.76 (1.90-114.57); NSAIDs, 27.77 (1.12-686.11); chocolate, 0.86 (0.18-4.06); ASA 1.63 (0.12-21.63); carbonated beverages, 4.24 (0.32-55.05); spicy food 7-16 times/month, 1.39 (0.17-11.17); and spicy food ≥ 20 times/month, 4.06 (0.47-34.59).
The relapse rate after short-term treatment with omeprazole was high. The consumption of citrus fruits and NSAIDs increased the possibility of GERD relapse.
目前尚无关于基层医疗患者胃食管反流病（GERD）复发相关因素的研究。
确定对质子泵抑制剂短期治疗反应良好的基层医疗患者中GERD复发的危险因素。
进行了一项队列研究，纳入GERD新发病例。患者接受奥美拉唑治疗4周。应用ReQuest问卷和危险因素问卷。在停药后4周和12周确定治疗成功率和复发率。对GERD复发的可能危险因素进行逻辑回归分析。
83例患者中，74例（89.16%）对治疗有反应。4周时36例患者（48.64%）症状复发，12周时13例患者（17.57%）症状复发，总体复发率为66.21%。多因素OR分析（95%CI）显示，停药后12周以下因素会增加GERD复发的可能性：基础教育水平及以下，24.95（1.92 - 323.79）；超重，1.76（0.22 - 13.64）；肥胖，0.25（0.01 - 3.46）；吸烟，0.51（0.06 - 3.88）；每月饮用4 - 12杯咖啡，1.00（0.12 - 7.84）；柑橘类水果，14.76（1.90 - 114.57）；非甾体抗炎药，27.77（1.12 - 686.11）；巧克力，0.86（0.18 - 4.06）；阿司匹林，1.63（0.12 - 21.63）；碳酸饮料，4.24（0.32 - 55.05）；每月食用辛辣食物7 - 16次，1.39（0.17 - 11.17）；每月食用辛辣食物≥20次，4.06（0.47 - 34.59）。
奥美拉唑短期治疗后的复发率较高。食用柑橘类水果和非甾体抗炎药会增加GERD复发的可能性。
