| 李常伟,罗梅,范文化.反流性食管炎质子泵抑制剂治疗失败 51例分析[J].安徽医药,2022,26(10):2090-2093. |
| 反流性食管炎质子泵抑制剂治疗失败 51例分析 |
| Failure of proton pump inhibitor therapy in 51 patients with reflux esophagitis |
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| DOI：10.3969/j.issn.1009-6469.2022.10.042 |
| 中文关键词: 食管炎，消化性 奥美拉唑 莫沙必利 logistic模型 |
| 英文关键词: Esophagitis, peptic Omeprazole Mosapride Logistic model |
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| 中文摘要: |
| 目的探讨反流性食管炎病人质子泵抑制剂治疗后失败的危险因素。方法回顾性分析重庆市大足区人民医院 2018年 4月至 2020年 4月 205例接受质子泵抑制剂治疗反流性食管炎病人临床资料，并依据治疗结果分为治疗成功组(胃镜检查食管黏膜完全愈合， 154例)、治疗失败组(胃镜检查食管黏膜愈合不完全或复发， 51例)。所有病人入院后给予奥美拉唑(质子泵抑制剂)或奥美拉唑联合莫沙必利(胃动力)治疗。统计并对比两组性别、年龄、民族、体质量指数( BMI)、是否吸烟、是否饮酒、家族史、是否焦虑、是否抑郁、治疗时间、是否幽门螺旋杆菌( Hp)感染、用药方式、疾病严重程度差异。再将两组有差异的信息纳入多因素 logistic回归分析模型，行量化赋值，以治疗结果为因变量(Y，失败 =1，成功 =0)，明确反流性食管炎病人经质子泵抑制剂治疗后失败的危险因素。结果两组性别、年龄、民族、家族史、治疗时间、 Hp感染对比差异无统计学意义( P> |
| 英文摘要: |
| Objective To investigate the risk factors for failure after proton pump inhibitor therapy in patients with reflux esophagi. tis.Methods The clinical data of 205 patients with reflux esophagitis treated with proton pump inhibitors in Chongqing Dazu DistrictPeople's Hospital from April 2018 to April 2020 were retrospectively analyzed.. According to the results of treatment, the patients weredivided into successful group (complete healing of esophageal mucosa by gastroscopy, 154 cases) and failed group (incomplete healingof esophageal mucosa by gastroscopy or recurrence, 51 cases). All patients were treated with omeprazole (proton pump inhibitor) oromeprazole plus mosapride (gastric motility) after admission. Gender, age, ethnicity, body mass index (BMI), smoking, drinking, familyhistory, anxiety, depression, treatment time, Helicobacter pylori (Hp) infection, medication methods and disease severity were comparedbetween the two groups. Then, the information with differences between the two groups was included in the multivariate logistic regres.sion analysis model, and the quantitative value was assigned. The treatment outcome was taken as the dependent variable (Y, failure =1, success =0) to identify the risk factors of failure in patients with reflux esophagitis after proton pump inhibitor treatment.Results There were no significant differences in gender, age, ethnicity, family history, treatment time and Hp infection between the two groups(P > 0.05). In the failed group, the proportions of patients with BMI>24 kg/m2, smoking, drinking, anxiety, depression, proton pump in. hibitor alone, and disease severity C-D were 70.59% (36/51) and 64.71% (33/51), 78.43% (40/51), 70.59% (36/51), 68.63% (35/51),64.71% (33/51), 62.75% (32/51), significantly increased than those in the successful treatment group 25.97% (40/154), 35.71% (55/154), 25.32% (39/154), 19.48% (30/154), 18.83% (29/154), 44.81% (69/154), 9.74% (15/154), and the differences were statisticallysignificant (P < 0.05). Multivariate Logistic regression analysis confirmed that BMI>24 kg/m2, smoking, alcohol consumption, anxiety, depression, proton pump alone and disease severity grade C-D were risk factors for failure after proton pump treatment for reflux esoph. agitis (P<0.05).Conclusion Patients with reflux esophagitis have many risk factors for treatment failure, such as BMI, smoking, alco.hol consumption, anxiety, depression, medication style, and disease severity, which should be paid attention to in clinical treatment. |
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