利那洛肽对功能性排便障碍的疗效及其影响因素  

Efficacy and influencing factors of linaclotide in functional defecation disorders

作　　者：冯奔畅 陈蓉蓉 朱锋 林琳[1] 王美峰[1] 姜柳琴[1] Feng Benchang;Chen Rongrong;Zhu Feng;Lin Lin;Wang Meifeng;Jiang Liuqin(Department of Gastroenterology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院消化内科,南京210029

出　　处：《中华消化杂志》2023年第12期828-833,共6页Chinese Journal of Digestion

摘　　要：目的探究利那洛肽对功能性排便障碍(FDD)患者的疗效及其影响因素。方法纳入2021年6月1日至2023年2月28日在南京医科大学第一附属医院就诊的FDD患者160例,根据随机数字表法随机分为利那洛肽组和聚乙二醇组,每组各80例,疗程均为4周。记录并比较患者治疗前后及两组患者间疗效、每周完全自发性排便(CSBM)次数,以及便秘患者症状自评量表(PAC-SYM)、数字分级评分法(NRS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。采用多因素logistic回归分析影响利那洛肽治疗FDD的因素(包含肛门直肠测压),用受试者操作特征曲线(ROC)分析危险因素对利那洛肽治疗FDD疗效的预测价值。统计学比较采用独立样本t检验、配对t检验和卡方检验。结果利那洛肽组和聚乙二醇组患者治疗后的每周CSBM次数均分别高于同组治疗前[(3.20±2.03)次比(2.44±2.09)次和(3.10±2.26)次比(2.58±2.06)次],差异均有统计学意义(t=-4.85、-5.91,均P<0.001)。利那洛肽组和聚乙二醇组治疗后PAC-SYM粪便性状、直肠症状、腹部症状评分和总分,以及NRS评分、SAS和SDS评分均低于同组治疗前[(1.41±0.96)分比(1.89±1.13)分、(0.95±0.49)分比(1.14±0.46)分、(0.69±0.57)分比(1.00±0.58)分、(0.96±0.43)分比(1.23±0.40)分、(1.54±1.11)分比(2.48±1.24)分、(43.54±6.26)分比(45.13±7.30)分、(42.10±7.95)分比(43.78±9.15)分和(1.36±1.09)分比(1.88±1.17)分、(0.83±0.40)分比(1.10±0.45)分、(0.81±0.60)分比(1.01±0.69)分、(0.91±0.42)分比(1.21±0.41)分、(1.90±1.17)分比(2.23±1.27)分、(43.55±7.72)分比(44.61±8.51)分、(40.00±6.71)分比(41.18±7.50)分];差异均有统计学意义(t=7.08、7.73、7.15、9.26、7.66、7.96、8.46和7.26、7.16、5.78、8.37、6.17、4.67、7.13,均P<0.001);利那洛肽组治疗后NRS评分低于聚乙二醇组,差异有统计学意义(t=-2.01,P=0.046)。利那洛肽组总有效率高于聚乙二醇组[77.5%(62/80)比62.5%(50/80)],差异有统�Objective To explore the efficacy and influencing factors of linaclotide in patients with functional defecation disorder(FDD).Methods From June 1,2021 to February 28,2023,at the First Affiliated Hospital of Nanjing Medical University,160 patients with FDD were enrolled and randomly divided into linaclotide group and polyethylene glycol group by using a random number table method,with 80 cases in each group,and the treatment course both was 4 weeks.The efficacy,weekly complete spontaneous bowel movement(CSBM),patient assessment of constipation symptom(PAC-SYM),numerical rating scale(NRS),Zung′s self-rating anxiety scale(SAS)and Zung′s self-rating depression scale(SDS)before and after treatment of linaclotide group and polyethyetylene glycol group were recorded and compared.Multivariate logistic regression analysis was performed to analyze the factors affected linaclotide in the treatment of FDD(including anorectal manometry).Receiver operating characteristic curve(ROC)was used to analyze the predictive value of risk factors on the efficacy of linaclotide in FDD.Independent sample t-test,paired t-test and chi-square test were used for statistical analysis.Results After treatment,the weekly CSBM frequencies of linaclotide group and polyethylene glycol group were both higher than those before treatment in the same group(3.20±2.03 vs.2.44±2.09,3.10±2.26 vs.2.58±2.06),and the differences were statistically significant(t=-4.85 and-5.91,both P<0.001).After treatment,PAC-SYM score of stool shape,rectal symptom,abdominal symptom and total score,NRS score,SAS score and SDS score of linaclotide group and polyethylene glycol group were all lower than those before treatment in the same group(1.41±0.96 vs.1.89±1.13,0.95±0.49 vs.1.14±0.46,0.69±0.57 vs.1.00±0.58,0.96±0.43 vs.1.23±0.40,1.54±1.11 vs.2.48±1.24,43.54±6.26 vs.45.13±7.30,42.10±7.95 vs.43.78±9.15 and 1.36±1.09 vs.1.88±1.17,0.83±0.40 vs.1.10±0.45,0.81±0.60 vs.1.01±0.69,0.91±0.42 vs.1.21±0.41,1.90±1.17 vs.2.23±1.27,43.55±7.72 vs.44.61±8.5

关 键 词：利那洛肽 聚乙烯二醇类 功能性排便障碍 便秘 

分 类 号：R574.62[医药卫生—消化系统]