Kawara Fumiaki, Fujita Tsuyoshi, Morita Yoshinori, Uda Atsushi, Masuda Atsuhiro, Saito Masaya, Ooi Makoto, Ishida Tsukasa, Kondo Yasuyuki, Yoshida Shiei, Okuno Tatsuya, Yano Yoshihiko, Yoshida Masaru, Kutsumi Hiromu, Hayakumo Takanobu, Yamashita Kazuhiko, Hirano Takeshi, Hirai Midori, Azuma Takeshi
Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
World J Gastroenterol. 2017 Mar 21;23(11):2060-2067. doi: 10.3748/wjg.v23.i11.2060.
To elucidate the factors associated with residual gastroesophageal reflux disease (GERD) symptoms in patients receiving proton pump inhibitor (PPI) maintenance therapy in clinical practice.
The study included 39 GERD patients receiving maintenance PPI therapy. Residual symptoms were assessed using the Frequency Scale for Symptoms of GERD (FSSG) questionnaire and the Gastrointestinal Symptom Rating Scale (GSRS). The relationships between the FSSG score and patient background factors, including the CYP2C19 genotype, were analyzed.
The FSSG scores ranged from 1 to 28 points (median score: 7.5 points), and 19 patients (48.7%) had a score of 8 points or more. The patients' GSRS scores were significantly correlated with their FSSG scores (correlation coefficient = 0.47, < 0.005). In erosive esophagitis patients, the FSSG scores of the CYP2C19 rapid metabolizers (RMs) were significantly higher than the scores of the poor metabolizers and intermediate metabolizers (total scores: 16.7 ± 8.6 7.8 ± 5.4, < 0.05; acid reflux-related symptom scores: 12 ± 1.9 2.5 ± 0.8, < 0.005). In contrast, the FSSG scores of the CYP2C19 RMs in the non-erosive reflux disease patients were significantly lower than those of the other patients (total scores: 5.5 ± 1.0 11.8 ± 6.3, < 0.05; dysmotility symptom-related scores: 1.0 ± 0.4 6.0 ± 0.8, < 0.01).
Approximately half of the GERD patients receiving maintenance PPI therapy had residual symptoms associated with a lower quality of life, and the CYP2C19 genotype appeared to be associated with these residual symptoms.
阐明在临床实践中接受质子泵抑制剂（PPI）维持治疗的胃食管反流病（GERD）患者残余症状的相关因素。
该研究纳入了39例接受PPI维持治疗的GERD患者。使用胃食管反流症状频率量表（FSSG）问卷和胃肠道症状评分量表（GSRS）评估残余症状。分析FSSG评分与患者背景因素（包括CYP2C19基因型）之间的关系。
FSSG评分范围为1至28分（中位数评分：7.5分），19例患者（48.7%）评分在8分及以上。患者的GSRS评分与FSSG评分显著相关（相关系数 = 0.47，<0.005）。在糜烂性食管炎患者中，CYP2C19快速代谢者（RMs）的FSSG评分显著高于慢代谢者和中间代谢者的评分（总分：16.7±8.6对7.8±5.4，<0.05；酸反流相关症状评分：12±1.9对2.5±0.8，<0.005）。相比之下，非糜烂性反流病患者中CYP2C19 RMs的FSSG评分显著低于其他患者（总分：5.5±1.0对11.8±6.3，<0.05；动力障碍症状相关评分：1.0±0.4对6.0±0.8，<0.01）。
接受PPI维持治疗的GERD患者中约一半存在与生活质量较低相关的残余症状，且CYP2C19基因型似乎与这些残余症状有关。
