沃诺普拉赞剂量升级的时间和预测因素在耐药胃食道逆流性疾病:长期观察性研究
Satoshi Shinozaki1,2, Hirotsugu Sakamoto2,3, Hiroyuki Osawa2
1Shinozaki Medical Clinic, Utsunomiya, Japan.
Digestion
|June 17, 2025
概括
在少数患者中,对于耐火性胃食道逆流性疾病 (GERD) 需要增加诺普拉桑 (VPZ) 的剂量. 预先存在的上胃疼痛预测需要更高的VPZ剂量,这有效地改善了GERD症状.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 诺普拉桑 (VPZ) 是胃食道逆流症 (GERD) 的标准治疗方法.
- 对于持续的GERD症状,建议每天增加剂量从10毫克到20毫克.
- 确定VPZ剂量升级的预测因素对于优化GERD管理至关重要.
研究的目的:
- 确定Vonoprazan (VPZ) 剂量升级的适当时间和预测因子,用于耐火性GERD患者.
- 分析影响需要增加VPZ剂量的因素.
主要方法:
- 对257名有症状的GERD患者进行了回顾性观察性研究.
- 医疗记录的分析,包括内镜检测结果和Izumo尺度得分.
- 卡普兰-梅尔分析和考克斯比例风险回归用于预测因素识别.
主要成果:
- 22%的患者需要VPZ剂量升级,平均随访时间为3.3年.
- 预先存在的上胃疼痛是剂量升级的重要预测因素 (一年率:69%与88%).
- 预先存在的便秘是负面预测因素;剂量升级在1个月内改善了GERD症状.
结论:
- 需要VPZ剂量升级的耐火性GERD发生率相对较低.
- 在VPZ开始前的表胃疼痛是需要剂量升级的独立预测因素.
- VPZ剂量升级有效地缓解了GERD症状.
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