52周雷贝拉唑治疗对胃食管反流病患者生活质量的远期影响

目的 了解52周雷贝拉唑治疗结束2～3年后胃食管反流病(GERD)患者生活质量的变化.方法 2007年11月至2008年2月,对多中心完成52周雷贝拉唑维持治疗2～3年后的GERD患者进行随访,其中糜烂性食管炎(EE)患者67例,非糜烂性胃食管反流病(NERD)患者31例,采用GERD相关生活质量量表(GERD-HRQL)和SF-36健康量表评估患者生活质最.结果 (1)与治疗前相比,EE患者GERD-HRQL评分从12.5分降至3.5分(Z=-5.242,P=0.000);NERD患者从20.0分降至14.0分(Z=-4.130,P=0.000).两组患者对生活总体满意度也均有显著上升(均P<0.01).(2)与完成52周治疗时相比,两组患者的GERD-HRQL评分无明显变化,分别为中位数2.0分比3.5分和5.0分比14.0分(均P>0.05).EE只在SF-36的精神健康维度评分低于前者(53±17)分比(61±17)分,t=-2.143,P=0.035].(3)随访时NERD组GERD-HRQL评分高于EE(中位数14.0分比3.5分,Z=-2.377,P=0.017),其余两组间差异无统计学意义.结论 长期维持量雷贝拉唑治疗可以改善GERD患者的生活质量,且疗效可以长时间持续,NERD患者酸反流症状较EE重,但总体生活质量两亚型之间差异无统计学意义.

Long-term impact on quality of life in patients with gastroesophageal reflux disease after 52-week rabeprazole treatment

Objective To investigate the longitudinal changes in quality of life (QoL) for gastroesophageal reflux disease (GERD) treated with 52-week rubeprasole over a period of 2-3 years. Methods A multi-center, open-label and randomized 52-week raberprazole trial was conducted in 67 eosinophilic esophagitis (EE) and 31 non-erosive reflux disease (NERD) patients. The follow-up period is 2-3 years after the treatment. Their QoL were evaluated using SF-36 Health Survey Questionnaire and GERD-HRQL scale. The results were compared with those acquired before and after a 52-week proton pump inhibitor (PPI) treatment. Results (1) Both EE and NERD patients improved significantly according to GERD-HRQL scale in scores of reflux symptoms as well as overall satisfaction (12.5 vs 3.5, 20.0 vs 14.0, both P < 0.01) versus the pre-therapy baseline. (2) Both EE and NERD patients had no significant difference in the scale of GERD-HRQL (2.0 vs 3.5, 5.0 vs 4.0, both P >0. 05) and most major domains of SF-36 questionnaire versus the post-therapy baseline(53±17 vs 61±17,t=-2.143, P=0.035). (3) The NERD patients had a higher score of reflux symptoms than the EE patients according to the GERD-HRQL Scale(14.0 vs 3.5, Z=2.377, P=0.017), however there were no significant differences between NERD and EE in 8 major domains of SF-36 questionnaire(P>0.05). Conclusion Long-term and low-dose PPI treatment achieves improvement both in reflux symptoms and QoL in GERD patients and such effects last a long time. At follow-ups, the reflux symptoms of NERD patients are more severe than EE patients. However, the overall QoL has shown little differences between these two subtypes.