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

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

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（NERO）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量。结果（1）与治疗前相比，EE患者GERD—HRQI。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。

Objective To investigate the longitudinal changes in quality of life （QoL） for gastroesophageal reflux disease （GERD） treated with 52-week rabeprazole 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 fallow-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 GERDHRQL 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.