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首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Influence of age on treatment with proton pump inhibitors in patients with laryngopharyngeal reflux disease: A prospective multicenter study
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Influence of age on treatment with proton pump inhibitors in patients with laryngopharyngeal reflux disease: A prospective multicenter study

机译：年龄对喉咽反流病患者质子泵抑制剂治疗的影响：一项前瞻性多中心研究

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IMPORTANCE: Several trials on the predictors of response to proton pump inhibitor (PPI) treatment of laryngopharyngeal reflux (LPR) have shown conflicting results. Furthermore, the influence of age in disease severity and response to PPI therapy is unclear. OBJECTIVE: To assess the difference in disease severity and response to PPI therapy according to age in patients with LPR. DESIGN, SETTING, AND PARTICIPANTS: Prospective multicenter study at 3 tertiary medical centers of 264 consecutive patients with LPR who were referred to the otolaryngology clinic from November 2010 to February 2012. INTERVENTIONS: Participants were prescribed 15 mg of lansoprazole (PPI) twice daily for 3 months. MAIN OUTCOMES AND MEASURES: Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and laryngopharyngeal reflux-health-related quality of life (LPR-HRQOL) were collected at baseline and at 1 and 3 months postbaseline. RESULTS: After 3 months, 35 patients were lost to follow-up and excluded; the remaining 229 patients included 135 men and 94 women. The oldest group (60-79 years; n = 111) showed higher baseline RSI (P < .001) and LPR-HRQOL (P < .001) scores than the 18- to 39-year-old (n = 35) and 40- to 59-year-old (n = 83) groups. However, baseline RFS scores showed no significant difference among age groups (P = .44). Within each age group, the RSI, RFS, and LPR-HRQOL improved significantly with PPI therapy (all P < .001); however, no significant difference in improvement of RSI (P = .59), RFS (P = .50), or LPR-HRQOL (P = .09) was seen among the groups. At 3-month follow-up, significantly more responders, defined as those whose RSI score improved by more than 50%, were found in the 18- to 39-year-old and 40- to 59-year-old groups (86%and 75%, respectively) than in the oldest group (57%) (P = .002), but there was no significant difference in proportion of responders among age groups at 1-month follow-up (P = .69). CONCLUSIONS AND RELEVANCE: In patients with LPR, age seems to affect the subjective symptoms and resulting impact on quality of life but not the laryngeal findings. Furthermore, older patients are more likely not to respond to PPI therapy than younger patients.
机译：重要提示：多项关于质子泵抑制剂（PPI）治疗喉咽反流（LPR）反应的预测因子试验显示出矛盾的结果。此外，尚不清楚年龄对疾病严重程度和对PPI治疗反应的影响。目的：根据年龄评估LPR患者的疾病严重程度和对PPI治疗的反应差异。设计，地点和参与者：2010年11月至2012年2月在3个三级医疗中心进行的前瞻性多中心研究，共264例LPR患者被转诊到耳鼻喉科诊所。干预措施：参与者处方兰索拉唑（PPI）15 mg，每天两次3个月。主要结果和测量指标：基线时以及基线后1和3个月，收集反流症状指数（RSI），反流发现评分（RFS）和喉咽反流健康相关生活质量（LPR-HRQOL）。结果：3个月后，有35例患者失访并被排除;其余229名患者包括135名男性和94名女性。年龄最大的组（60-79岁; n = 111）显示的基线RSI（P <.001）和LPR-HRQOL（P <.001）得分高于18至39岁（n = 35）和40至59岁（n = 83）组。但是，基线RFS评分在各年龄组之间无显着差异（P = .44）。在每个年龄组中，PPI治疗显着改善了RSI，RFS和LPR-HRQOL（所有P <0.001）;但是，两组之间在RSI（P = .59），RFS（P = .50）或LPR-HRQOL（P = .09）的改善上没有显着差异。在3个月的随访中，在18至39岁组和40至59岁组中发现了更多的响应者，这些响应者的RSI得分提高了50％以上（86％分别比年龄最大的组（57％）和75％（P = .002）大，但在1个月的随访中，不同年龄组的应答者比例没有显着差异（P = .69）。结论和相关性：LPR患者的年龄似乎影响主观症状并因此影响生活质量，但不影响喉部检查结果。此外，老年患者比年轻患者对PPI治疗无反应的可能性更大。

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