质子泵抑制剂对胃食管反流病夜间反流症状的疗效——华北地区数据分析  

Efficacy of Proton Pump Inhibitors on Nighttime Reflux Symptoms in Patients With Gastroesophageal Reflux Disease in North China

作　　者：孙恺蒂 马双 惠洋洋[1] 王彬[1] 朱兰平 陈鑫[1] 王邦茂[1] SUN Kaidi;MA Shuang;HUI Yangyang;WANG Bin;ZHU Lanping;CHEN Xin;WANG Bangmao(Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052)

机构地区：[1]天津医科大学总医院消化科,300052

出　　处：《胃肠病学》2021年第6期325-331,共7页Chinese Journal of Gastroenterology

基　　金：中国医疗保健国际交流促进会项目(ZG-2017-12151019);天津市科技计划项目(19PTZWHZ00090);天津市研究生科研创新项目(2019YJSB108)。

摘　　要：背景:胃食管反流病(GERD)与睡眠障碍密切相关。质子泵抑制剂(PPIs)是改善GERD患者反流症状的主要手段。目的:探讨PPIs在我国华北地区一般GERD人群中对夜间反流症状及其相关睡眠障碍的疗效。方法:本研究为一项多中心前瞻性观察性研究。研究纳入2017年7月—2018年3月就诊于华北地区11家三级医院、有夜间烧心或反酸症状并接受PPIs治疗的成人GERD患者,通过日记卡和问卷调查采集夜间反流症状和反流相关睡眠障碍相关信息,以匹兹堡睡眠质量指数(PSQI)评估睡眠质量。分析PPIs治疗4周后的缓解率以评估药物疗效。结果:共750例GERD患者纳入最终分析,其中78.0%存在夜间反流相关睡眠障碍,56.9%睡眠质量不佳(PSQI评分>5)。PPIs治疗4周后,51.3%的患者夜间反流症状得到缓解,夜间反流症状和反流相关睡眠障碍完全缓解率分别为32.5%和51.5%;PSQI评分从基线期的6.82±3.38下降至4.56±2.50(P<0.05)。结论:PPIs治疗可有效缓解华北地区一般GERD人群的夜间反流症状及其相关睡眠障碍,提高睡眠质量。Background:Gastroesophageal reflux disease(GERD)is strongly associated with sleep disturbances.Proton pump inhibitors(PPIs)are the main treatment to improve the reflux symptoms in GERD patients.Aims:To investigate the efficacy of PPIs on nighttime reflux symptoms and associated sleep disturbances in general GERD population in North China.Methods:In this multicenter,prospective observational study,adult GERD patients with nighttime heartburn or regurgitation were recruited from 11 tertiary hospitals in North China during July 2017 to March 2018.All the patients received oral PPIs treatment.Data on nighttime reflux symptoms and associated sleep disturbances were obtained by patient diary and self-report questionnaire,the quality of sleep was defined by the Pittsburgh Sleep Quality Index(PSQI).The efficacy of PPIs was estimated by the relief rate after 4-week treatment.Results:Of the 750 GERD patients analyzed,585(78.0%)reported nighttime reflux-associated sleep disturbances,and 427(56.9%)were defined as poor sleepers with a PSQI score>5.After 4-week PPIs treatment,51.3%of the patients achieved a relief of nighttime reflux symptoms.The complete relief rates for nighttime reflux symptoms and associated sleep disturbances were 32.5%and 51.5%,respectively.PSQI score was significantly improved from 6.82±3.38 at baseline to 4.56±2.50 after 4-week PPIs treatment(P<0.05).Conclusions:PPIs treatment provides an effective relief of nighttime reflux symptoms and associated sleep disturbances and improving the sleep quality in general GERD population in North China.

关 键 词：胃食管反流病 夜间反流症状 睡眠障碍 质子泵抑制剂 

分 类 号：R57[医药卫生—消化系统]