心理因素对质子泵抑制剂维持治疗老年非糜烂性反流病患者生活质量的影响

Effects of psychological factors on quality of life in aged patients with non-erosive reflux disease undermaintenance treatment of proton pump inhibitors

目的探讨心理因素对质子泵抑制剂维持治疗的老年非糜烂性反流病（NERD）患者生活质量的影响。方法选择我院已确诊且用质子泵抑制剂（埃索美拉唑）维持治疗半年以上老年NERD患者76例，根据临床症状，参照反流性疾病问卷，将76例患者分为有症状组和无症状组，分别对两组患者进行Zung焦虑自评量表（SAS）和Zung抑郁自评量表（SDS）评分，并同时用胃食管反流病相关生活质量量表（GERD-HRQL）和SF-36健康量表评估患者生活质量。结果与无症状组及健康对照组比较，有症状组SAS、SDS评分明显升高（P〈0．05），GERD-HRQL评分增高（y。：19．689，P％0．01），SF-36除生理功能外的其他7个健康维度评分明显降低（P％0．05）。相关分析发现，有症状组sAS、SDS得分与GERD-HRQL评分呈正相关（P〈0．01），与SF-36除生理功能外的其他7个健康维度评分呈负相关（P〈O．05）。结论质子泵抑制剂疗效差的老年NERD患者，多数合并心理问题，生活质量明显下降；老年NERD患者心理异常与生活质量下降明显相关。

Objective To explore the effects of psychologicM disorders on qualityoflife of elderly patients with non-erosive reflux disease （NERD） under maintenance treatment of proton pump inhibitors （PPls）. Methods A total of 76 elderly patients with NERD treated by proton pump inhibitors （maintenance treatment of Esomeprazole over half a year） were enrolled. They were classified into symptom group aged （66.5±8.2） years （n=35） and symptom group aged（68.2±6.9） years （n=41） according to reflux symptoms, with 20 healthy people aged （65.4± 8.8） years as control. The subjects completed the questionnaires on psychological status including self-rating anxiety scale （SAS） and self-rating depression scale （SDS） and their quality of life was evaluated by gastroesophageal heath related quality-of-life instrument（GERD-HROL） and medical outcomes study short form（SF-36）. Results Scores of SAS and SDS were significantly higher in symptom group （54.9＋6.2, 57.9＋8.6） than in symptomless（37.9±8.7, 42.7±7.9） and health control group （38.9±7.2, 43.1±8.9）, all （P〈0.05）, but there was no difference between symptomless and health control group. The rates of anxiety and depression in symptom group （51.4%, 57.1%） were increased as compared with symptomless （12.2%, 9.8%）and health control group（0.0%, 5.0%）. Scores of GERD-HRQL in symptom group were higher than in symptomless group （21.4± 5.0 vs. 4.5±2.2, t = 19.76, P% O. 01） while the indexes such as body pain, vitality, social function, affection, mental and whole health in score of SF-36 besides physiology function were lower in symptom group than in symptomless and control groups （P〈0.05 or P%0.01）. Only the significant differences in mental and whole health of SF-36 were found between symptomless and control groups （P%0.01）. Correlation analysis revealed that SAS and SDS scores were positively correlated with scores of GERD-HRQL in symptom group（P〈0.01） and negatively with all dimensions of SF-36 but physical function （P〈 0.05）. Conclusions Most of elderly symptomatic patients with NERDtreated by PPI are in psychological disorders which results in lower quality of life.