徐健 1 , 劉翱 2 , 鄒雷 3
  • 1 成都軍區(qū)昆明總醫(yī)院 昆明醫(yī)學(xué)院教學(xué)醫(yī)院(云南昆明 650032);;
  • 2 成都軍區(qū)昆明總醫(yī)院呼吸內(nèi)科;;
  • 3 云南省人民醫(yī)院呼吸內(nèi)科;

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(duì)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(wèn)卷調(diào)查表》結(jié)果分為GER陽(yáng)性組和GER陰性組;同時(shí)選擇健康人2O例作為對(duì)照組。檢測(cè)三組呼出氣冷凝液(EBC)pH值和肺通氣功能(FEV1、FEV1/FVC、FEV1%pred)。結(jié)果  AECOPD合并GER的發(fā)病率為30.8%(20/65)。GER陽(yáng)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?dú)?PaCO2、PaO2 )等方面無(wú)顯著差異(P均 gt;0.05)。GER陽(yáng)性AECOPD患者EBC的pH值顯著低于GER陰性AECOPD患者和對(duì)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(duì)照組(P lt;0.05)。GER陽(yáng)性AECOPD患者肺通氣功能顯著低于GER陰性組。結(jié)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(jìn)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(duì)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(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 08(6): 448-451. doi: 復(fù)制

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(yīng)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(guān)系探討.中國(guó)呼吸與危重監(jiān)護(hù)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(duì)慢性阻塞性肺病患者肺通氣功能的影響.中國(guó)臨床醫(yī)學(xué),2003,10:821-832..
13. 胃食管反流病研究協(xié)作組.反流性疾病問(wèn)卷在胃食管反流病診斷中的價(jià)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..
  1. 1. Kiljander TO,Laitinen Jo.,The prevalence of gastroesophageal reflux disease in adult asthmatics.Chest,2004,126:1490-1494..
  2. 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. 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. 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. 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. 6. Mokhlesi B.Clinical implications of gastroesophageal reflux disease and swallowing dysfunction in COPD.Am J Respir Med,2003,2,117-121..
  7. 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. 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. 9. 李翠萍,劉雪白,周秀梅,等.慢性阻塞性肺疾病應(yīng)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. 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(guān)系探討.中國(guó)呼吸與危重監(jiān)護(hù)雜志,2007,6:177-193..
  11. 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. 12. 余濤,于皆平,耿紅,等.抗胃食管反流治療對(duì)慢性阻塞性肺病患者肺通氣功能的影響.中國(guó)臨床醫(yī)學(xué),2003,10:821-832..
  13. 13. 胃食管反流病研究協(xié)作組.反流性疾病問(wèn)卷在胃食管反流病診斷中的價(jià)值.中華消化雜志,2003,23:651-654..
  14. 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. 15. Haritonov SA.Barnes P Exhaled markers of pulmonary disease.Am J Respir Crit Care Med,2001,163:1693-1722..
  16. 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. 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..
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