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女性性别是根除幽门螺杆菌后功能性消化不良缓解的不良预测因素:一项前瞻性、多中心韩国试验

Female Gender is a Poor Predictive Factor of Functional Dyspepsia Resolution after Eradication: A Prospective, Multi-center Korean Trial.

作者信息

Kim Sung Eun, Kim Nayoung, Park Seon Mee, Kim Won Hee, Baik Gwang Ho, Jo Yunju, Park Kyung Sik, Lee Ju Yup, Shim Ki-Nam, Kim Gwang Ha, Lee Bong Eun, Hong Su Jin, Park Seon-Young, Choi Suck Chei, Oh Jung Hwan, Kim Hyun Jin

机构信息

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Korean J Gastroenterol. 2018 Dec 25;72(6):286-294. doi: 10.4166/kjg.2018.72.6.286.

Abstract

BACKGROUND/AIMS: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy.

METHODS

This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing eradication therapy.

RESULTS

A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing eradication therapy.

CONCLUSIONS

Female gender was found to predict poor response in FD patients despite eradication. Furthermore, successful eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.

摘要

背景/目的:功能性消化不良(FD)的预测因素仍存在争议。因此,我们试图研究根除治疗后FD患者的症状反应,并采用预测因素分析来确定根除治疗开始一年后FD缓解的显著因素。

方法

对65例符合罗马III标准且有幽门螺杆菌感染的FD患者进行了这项前瞻性、多中心临床试验。通过开始根除治疗一年后的分析来确定症状反应和预测反应不佳的因素。

结果

共有63例患者完成了一年的随访。将根除成功组(n = 60)和根除失败组(n = 3)在一年时的FD反应率进行比较,结果如下:完全缓解分别为73.3%和0.0%,满意缓解分别为1.7%和0.0%,部分缓解分别为10.0%和33.3%,难治性缓解分别为15.0%和66.7%(p = 0.013)。单因素分析显示持续幽门螺杆菌感染(p = 0.021)、女性(p = 0.025)以及研究期间使用FD药物(p = 0.013)与一年时FD反应不佳相关。然而,年龄、吸烟、饮酒和基础疾病未发现影响反应。最后,多因素分析显示女性(比值比,4.70;95%可信区间,1.17 - 18.88)是开始根除治疗一年后FD反应不佳的唯一独立危险因素。

结论

尽管进行了根除治疗,但发现女性预测FD患者反应不佳。此外,成功根除似乎与FD改善相关,但未根除患者数量过少,无法得出结论。

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