Study On The Factors Influencing The Outcome Of Patients With Functional Dyspepsia

Objective:To explore the effects of anxiety,depression,somatization and course of disease on the prognosis of patients with FD,and to follow up and compare the effectiveness of GAD-7 and GAD-2 in evaluating anxiety,and to analyze the effect of brain neurotransmitter power on the outcome of the disease.Methods:362 patients with FD diagnosed according to Rome Ⅳ criteria were collected and followed up by telephone.The changes of disease need to be evaluated before and after follow-up.The dyspeptic symptom severity scale(DSS),somatization symptom cluster scale(modified PHQ-15),generalized anxiety disorder scale(GAD-7,GAD-2),depression symptom cluster scale(PHQ-9)and Nipin dyspepsia index short form(NDI)were evaluated.Before follow-up,the brain fluctuation map was completed to detect the levels of six kinds of neurotransmitters.Then the effects of the above factors on the outcome of FD patients were analyzed horizontally and longitudinally,and the effectiveness of GAD-7 and GAD-2 in evaluating anxiety was compared,and the effect of brain neurotransmitter power on disease outcome was analyzed.The statistical methods were independent sample t-test,chi-square test,Spearman correlation analysis,binary Logistic regression and multiple linear regression.Results:A total of 321 FD patients who met the Rome Ⅳ criteria were included in the study.When the improvement rate of the total symptom score was 50%,when there was no improvement,there were 100 cases in the improvement group(31.2%)and 221 cases in the non-improvement group(68.8%).After follow-up,there were 262 cases in the improvement group(81.6%)and 59 cases in the non-improvement group(18.4%).The data of dyspepsia severity(DSS),anxiety(GAD-7,GAD-2),depression(PHQ-9)and quality of life(NDI)of FD patients before and after follow-up were analyzed by paired sample t-test.It was found that there were significant differences in DSS,GAD-7,GAD-2 and NDI scales before and after follow-up(P<0.05).Binary Logistic regression showed that whether GAD-7 scale or GAD-2 scale was used to evaluate anxiety,the cross-sectional factors affecting the changes of symptoms in FD patients before follow-up were depression PHQ-9(OR=-0.089,95%CI:0.852～0.982,P=0.014)and age(OR=-0.032,95%CI:0.945～0.993,P=0.012).When GAD-7 scale was used to evaluate anxiety,the longitudinal influencing factor of FD patients’ symptoms after follow-up was anxiety GAD-7(OR=-0.106,95%CI:0.842～0.961,P=0.002).When GAD-2 scale was used to evaluate anxiety,the longitudinal influencing factor was depression PHQ-9(OR=-0.100,95%CI:0.845～0.969,P=0.004).Multiple linear regression analysis showed that when anxiety was assessed by GAD-7 scale,the horizontal factors affecting the quality of life of FD patients before follow-up were GAD-7(β=0.192,P=0.004),somatization(β=-0.152,P=0.013),PHQ-9(β=0.235,P=0.001)and education level,which were compared with junior college and above,primary school(β=0.235,P=0.003),junior middle school(β=0.210,P=0.008)and senior high school(β=0.134,P=0.040)is worse than that of junior college or above.When anxiety was assessed with GAD-2 scale,the horizontal factors affecting the quality of life of FD patients before follow-up were anxiety GAD-2(β=0.214,P=0.000),somatization(β=-0.170,P=0.006),PHQ-9(β=0.252,P=0.000)and education level,which were compared with university,primary school(β=0.252,follow-up study shows that GAD-7 is better in evaluating anxiety.These results suggest that anxiety is the most important factor affecting the long-term symptoms and quality of life of FD patients.It is necessary to select a reasonable scale to evaluate anxiety,which is helpful to further study and evaluate the factors affecting the outcome of FD patients and improve the quality of life of FD patients.