目的 了解胃食管反流(GER)在慢性阻塞性肺疾病急性加重(AECOPD)住院患者中的發(fā)病率,以及GER對AECOPD患者氣道酸堿度及肺通氣功能的影響。方法 選擇AECOPD住院患者65例,根據(jù)《反流問卷調查表》結果分為GER陽性組和GER陰性組;同時選擇健康人2O例作為對照組。檢測三組呼出氣冷凝液(EBC)pH值和肺通氣功能(FEV1、FEV1/FVC、FEV1%pred)。結果 AECOPD合并GER的發(fā)病率為30.8%(20/65)。GER陽性和GER陰性AECOPD患者在年齡、性別、體重指數(shù)(BMI)、血漿白蛋白(Alb)、血氣(PaCO2、PaO2 )等方面無顯著差異(P均 gt;0.05)。GER陽性AECOPD患者EBC的pH值顯著低于GER陰性AECOPD患者和對照組[6.00±0.75比6.76±0.77和7.97±0.12,P均 lt;0.05],GER陰性AECOPD患者也顯著低于對照組(P lt;0.05)。GER陽性AECOPD患者肺通氣功能顯著低于GER陰性組。結論 AECOPD患者存在一定程度的氣道酸化,GER在AECOPD患者中有較高的發(fā)病率,GER使AECOPD氣道酸化更明顯,并可能是促進COPD發(fā)生發(fā)展的重要因素。
引用本文: 徐健,劉翱,鄒雷. 胃食管反流對慢性阻塞性肺疾病急性加重氣道酸堿度和肺通氣功能的影響. 中國呼吸與危重監(jiān)護雜志, 2008, 08(6): 448-451. doi: 復制
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13. | 胃食管反流病研究協(xié)作組.反流性疾病問卷在胃食管反流病診斷中的價值.中華消化雜志,2003,23:651-654.. |
14. | Kostikas K,Papatheodorou G,Ganas K,et al.pH in expired breath condensate of patients with infammatory airways diseases.Am J Respir Crit Care Med,2002,165:1364-1370.. |
15. | Haritonov SA.Barnes P Exhaled markers of pulmonary disease.Am J Respir Crit Care Med,2001,163:1693-1722.. |
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- 1. Kiljander TO,Laitinen Jo.,The prevalence of gastroesophageal reflux disease in adult asthmatics.Chest,2004,126:1490-1494..
- 2. 1 Dent J,El-Scrag HB,Wallander MA,et al.Epidemiology of gastrooesophageal reflux disease:a systematic review.Gut,2005,54:710-717..
- 3. Debley JS,Carter ER,Redding GJ,et al.Prevalence and impact of gastroesophageal reflux in adolescents with asthma:a populationbased study.Pediatr Pulmonol,2006,41:475-481..
- 4. Mokhelsi B,Morris AL,Huang CF,et al.Increased prevalence of gastroesophageal reflux in patients with COPD.Chest,2001,1 19:1043-1048..
- 5. Shimizu Y,Dobashi K,Zhao JJ,et al.Proton Proton pump inhibitor improves breath marker in moderate asthma with gastroesophageal reflux disease.Respiration,2007,74:558-564..
- 6. Mokhlesi B.Clinical implications of gastroesophageal reflux disease and swallowing dysfunction in COPD.Am J Respir Med,2003,2,117-121..
- 7. Phulpoto MA,Qayyum S,Rizvi N,et al.Proportion of gastroesophageal reflux symptoms in patients with chronic obstructive pulmonary disease.J Pak Med Assoc,2005.55:276-279..
- 8. Mokhlesi B,Morris AL,Huang CF,et al.Increased prevalence of gastroesophageal reflux symptoms in patients with COPD.Chest,2001,19:1043-1048..
- 9. 李翠萍,劉雪白,周秀梅,等.慢性阻塞性肺疾病應用抗胃食管反流治療的探討.中華I臨床醫(yī)師雜志(電子版),2007,1:105-106..
- 10. 王萍,秦雪冰,王瑞娟,等.胃食管反流與慢性阻塞性肺疾病急性加重的關系探討.中國呼吸與危重監(jiān)護雜志,2007,6:177-193..
- 11. Kempainen RR,Savik K,Whelan TP,et al.High prevalence of proximal and distal gastroesophageal reflux disease in advanced COPD.Chest,2007,131:1666-1671..
- 12. 余濤,于皆平,耿紅,等.抗胃食管反流治療對慢性阻塞性肺病患者肺通氣功能的影響.中國臨床醫(yī)學,2003,10:821-832..
- 13. 胃食管反流病研究協(xié)作組.反流性疾病問卷在胃食管反流病診斷中的價值.中華消化雜志,2003,23:651-654..
- 14. Kostikas K,Papatheodorou G,Ganas K,et al.pH in expired breath condensate of patients with infammatory airways diseases.Am J Respir Crit Care Med,2002,165:1364-1370..
- 15. Haritonov SA.Barnes P Exhaled markers of pulmonary disease.Am J Respir Crit Care Med,2001,163:1693-1722..
- 16. Manterola C,Munoz S,Grande L,et al.Initial validation of a ques tionnaire for detecting gastroesophageal reflux disease in epidemiological settings.J Clin Epidemiol,2002,55:1041-1045..
- 17. Phulpoto MA,Qayyum S,Rizvi N,et al.Proportion of gastroesophageal reflux symptoms in patients with chronic obstructive pulmonary disease.J Pak Med Assoc,2005,55:276-279..