Kamei Daigo, Kamei Yuiko, Nagano Masashi, Mineshima Michio, Nitta Kosaku, Tsuchiya Ken
Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
BMC Gastroenterol. 2020 Jan 31;20(1):26. doi: 10.1186/s12876-020-1179-6.
Hemodialysis patients are prone to constipation, which can adversely affect their quality of life (QOL). Elobixibat, a highly selective inhibitor of the ileal bile acid transporter, can increase the bile acid level in the colon and, subsequently, enhance colonic motility and secretion. In hemodialysis patients with chronic constipation, it may have a novel action mechanism. However, the effect of elobixibat on such patients' QOL had not been reported. This study aimed to evaluate the effect of elobixibat on the QOL of hemodialysis patients with chronic constipation.
This was a multicenter, observational study that used the Japanese version of the Patient Assessment of Constipation-Quality of Life (PAC-QOL) questionnaire on 27 patients (18 men and nine women, age range 47-90 years), who satisfied the Rome 3 diagnostic criteria for functional constipation and were already taking other drugs for constipation. These patients were administered elobixibat 10 mg/day and were asked to respond to the PAC-QOL questionnaire at baseline and after 4 weeks. Bayesian statistics were used to confirm our results.
The number of spontaneous bowel movements per week increased significantly from 2.6 ± 1.2 to 4.1 ± 2.1 (p < 0.001), and the Bristol Stool Form Scale score significantly improved from 1.9 ± 0.8 to 3.6 ± 0.7 (p < 0.001). The Cronbach's alpha was 0.95, and the Guttman split-half reliability coefficient was 0.90. There were significant decreases in the physical discomfort scores from 1.94 ± 0.79 to 0.97 ± 0.72 (p < 0.001); psychosocial discomfort from 1.16 ± 0.93 to 0.63 ± 0.58 (p < 0.001); worries/ concerns from 1.84 ± 0.73 to 1.27 ± 0.59 (p < 0.001), and satisfaction from 2.79 ± 0.61 to 1.98 ± 0.77 (p < 0.001). The total PAC-QOL score significantly decreased from 1.83 ± 0.79 to 1.17 ± 0.56 (p < 0.001). Bayesian statistics confirmed the results' significance.
Elobixibat reduced the PAC-QOL scores for hemodialysis patients with chronic constipation and improved the patients' QOL. It may serve as a new option for treating constipation in hemodialysis patients.
血液透析患者易患便秘，这会对他们的生活质量（QOL）产生不利影响。依洛比昔巴特是一种回肠胆汁酸转运体的高度选择性抑制剂，可提高结肠中的胆汁酸水平，进而增强结肠蠕动和分泌。在患有慢性便秘的血液透析患者中，它可能具有一种新的作用机制。然而，依洛比昔巴特对这类患者生活质量的影响尚未见报道。本研究旨在评估依洛比昔巴特对患有慢性便秘的血液透析患者生活质量的影响。
这是一项多中心观察性研究，使用日本版的便秘患者生活质量评估（PAC-QOL）问卷对27例患者（18例男性和9例女性，年龄范围47 - 90岁）进行调查，这些患者符合罗马Ⅲ型功能性便秘诊断标准且已在服用其他治疗便秘的药物。给予这些患者每天10毫克依洛比昔巴特，并要求他们在基线时和4周后回答PAC-QOL问卷。采用贝叶斯统计来确认我们的结果。
每周自发排便次数从2.6±1.2显著增加至4.1±2.1（p<0.001），布里斯托大便性状量表评分从1.9±0.8显著改善至3.6±0.7（p<0.001）。克朗巴哈系数为0.95，古特曼折半信度系数为0.90。身体不适评分从1.94±0.79显著降至0.97±0.72（p<0.001）；心理社会不适从1.16±0.93降至0.63±0.58（p<0.001）；担忧/顾虑从1.84±0.73降至1.27±0.59（p<0.001），满意度从2.79±0.61降至1.98±0.77（p<0.001）。PAC-QOL总评分从1.83±0.79显著降至1.17±0.56（p<0.001）。贝叶斯统计证实了结果的显著性。
依洛比昔巴特降低了患有慢性便秘的血液透析患者的PAC-QOL评分并改善了患者的生活质量。它可能成为治疗血液透析患者便秘的一种新选择。
