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Am J Gastroenterol:PPI无应答患反流病患者症状知觉相关因素研究

2017-09-15 zhangfan MedSci原创

研究发现对于PPI无应答且pH阻抗正常的反流病患者心理困扰,生活质量降低以及吞咽困难感觉与反流病症状相关,而对于PPI抵抗且pH阻抗异常的患者,患者报告的症状严重程度与生理差异有关,而不是心理社会因素

统计发现高达50%的反流症患者质子泵抑制剂(PPI)治疗后不能达到满意的症状控制效果。近日研究人员对PPI无应答患者的症状知觉相关的因素进行了研究。

这项前瞻性观察性队列研究于2014年9月至2017年1月在单一学术医学中心进行,对无应答患者进行24小时的阻抗pH监测,通过问卷,考察病人报告的症状严重程度、生活质量(QOL)和心理社会窘迫,根据酸暴露时间 (AET)、反流相关症状 (SRA)以及反流超敏性(RHS)对患者分层,研究的主要终点是GerdQ≥8的严重胃食管返流病。

研究招募患者192人,其中阻抗正常组125人,包括-AET/-SRA组72人,+AET组42人, -AET/+SRA组11人;阻抗异常组67人,包括,功能异常患者-AET/-SRA组39人,症状异常患者+AET组16人以及RHS组12人。对于阻抗正常-AET/-SRA组,低龄、吞咽困难评分增高、QOL异常以及症状指数高与GerdQ≥8的严重胃食管返流病相关;对于+AET组,反流相关症状增多以及远端收缩积分降低与GerdQ≥8的严重胃食管返流病相关;对于功能异常-AET/-SRA组,QOL异常以及吞咽困难评分与严重的胃食管返流病相关。

研究发现对于PPI无应答且pH阻抗正常的反流病患者心理困扰,生活质量降低以及吞咽困难感觉与反流病症状相关,而对于PPI抵抗且pH阻抗异常的患者,患者报告的症状严重程度与生理差异有关,而不是心理社会因素。

原始出处:


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    2018-08-26 许安
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  7. 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    2017-09-17 feifers
  8. [GetPortalCommentsPageByObjectIdResponse(id=1711194, encodeId=92a61e111945a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Feb 03 13:12:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071905, encodeId=440720e19055c, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Aug 26 14:12:00 CST 2018, time=2018-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046121, encodeId=48d3204612115, content=<a href='/topic/show?id=010b3e767b2' target=_blank style='color:#2F92EE;'>#反流病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37767, encryptionId=010b3e767b2, topicName=反流病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sat Aug 25 13:12:00 CST 2018, time=2018-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064198, encodeId=48c1206419834, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Jan 08 13:12:00 CST 2018, time=2018-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758731, encodeId=bede1e58731ee, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Sun Oct 08 21:12:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457473, encodeId=853b145e47338, content=<a href='/topic/show?id=4159e25296d' target=_blank style='color:#2F92EE;'>#相关因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72529, encryptionId=4159e25296d, topicName=相关因素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19655942413, createdName=zzc2213, createdTime=Sun Sep 17 01:12:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571596, encodeId=e47715e159614, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Sun Sep 17 01:12:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244732, encodeId=e1a9244e3284, content=继续学习中谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Sep 16 21:37:18 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244731, encodeId=140e244e31e5, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Sep 16 21:37:12 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244322, encodeId=f45d244322ad, content=谢谢.学习受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Sep 15 13:42:04 CST 2017, time=2017-09-15, status=1, ipAttribution=)]
    2017-09-16 往日如昨

    继续学习中谢谢

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1711194, encodeId=92a61e111945a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Feb 03 13:12:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071905, encodeId=440720e19055c, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Aug 26 14:12:00 CST 2018, time=2018-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046121, encodeId=48d3204612115, content=<a href='/topic/show?id=010b3e767b2' target=_blank style='color:#2F92EE;'>#反流病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37767, encryptionId=010b3e767b2, topicName=反流病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sat Aug 25 13:12:00 CST 2018, time=2018-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064198, encodeId=48c1206419834, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Jan 08 13:12:00 CST 2018, time=2018-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758731, encodeId=bede1e58731ee, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Sun Oct 08 21:12:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457473, encodeId=853b145e47338, content=<a href='/topic/show?id=4159e25296d' target=_blank style='color:#2F92EE;'>#相关因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72529, encryptionId=4159e25296d, topicName=相关因素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19655942413, createdName=zzc2213, createdTime=Sun Sep 17 01:12:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571596, encodeId=e47715e159614, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Sun Sep 17 01:12:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244732, encodeId=e1a9244e3284, content=继续学习中谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Sep 16 21:37:18 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244731, encodeId=140e244e31e5, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Sep 16 21:37:12 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244322, encodeId=f45d244322ad, content=谢谢.学习受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Sep 15 13:42:04 CST 2017, time=2017-09-15, status=1, ipAttribution=)]
    2017-09-16 往日如昨

    学习了谢谢分享

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1711194, encodeId=92a61e111945a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Feb 03 13:12:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071905, encodeId=440720e19055c, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Aug 26 14:12:00 CST 2018, time=2018-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046121, encodeId=48d3204612115, content=<a href='/topic/show?id=010b3e767b2' target=_blank style='color:#2F92EE;'>#反流病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37767, encryptionId=010b3e767b2, topicName=反流病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sat Aug 25 13:12:00 CST 2018, time=2018-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064198, encodeId=48c1206419834, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Jan 08 13:12:00 CST 2018, time=2018-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758731, encodeId=bede1e58731ee, content=<a href='/topic/show?id=1a675894241' target=_blank style='color:#2F92EE;'>#无应答#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58942, encryptionId=1a675894241, topicName=无应答)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71ca37362043, createdName=12498717m78(暂无昵称), createdTime=Sun Oct 08 21:12:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457473, encodeId=853b145e47338, content=<a href='/topic/show?id=4159e25296d' target=_blank style='color:#2F92EE;'>#相关因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72529, encryptionId=4159e25296d, topicName=相关因素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19655942413, createdName=zzc2213, createdTime=Sun Sep 17 01:12:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571596, encodeId=e47715e159614, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Sun Sep 17 01:12:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244732, encodeId=e1a9244e3284, content=继续学习中谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Sep 16 21:37:18 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244731, encodeId=140e244e31e5, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Sep 16 21:37:12 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244322, encodeId=f45d244322ad, content=谢谢.学习受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Sep 15 13:42:04 CST 2017, time=2017-09-15, status=1, ipAttribution=)]
    2017-09-15 清风拂面

    谢谢.学习受益匪浅

    0

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