摘要
目的 探讨胃食管返流 (GER)与成人中、重度支气管哮喘的症状相关性 ,了解 2 4h食管pH监测对哮喘合并GER的诊断价值及抗返流治疗对合并GER的哮喘患者症状的影响。方法 对 2 6例常规治疗后仍有顽固性咳嗽等症状的成人哮喘患者进行 2 4h食管pH监测 ,严格记录监测期间患者出现的各种症状 ,每小时记录 1次呼气峰流速 (PEF)。筛选出适当病例分组抗返流治疗并观察疗效。结果 2 6例中有 15例DeMeester总积分≥ 14 72 ,2例虽DeMeester总积分 <14 72 ,但咳嗽与返流的症状相关概率 (SAP)≥ 95 % ,共筛选出 17例。将 17例患者随机分为治疗组 (9例 )和对照组 (8例 )。经抗返流治疗后 ,治疗组咳嗽、胸闷和胸骨后烧灼感等症状均较对照组有明显改善 ,2 4hPEF波动率治疗前 [(3 8± 8) % ]、后 [(16± 3 ) % ]比较差异有显著性 (P <0 0 5 )。结论 (1)中、重度支气管哮喘患者具有较高的GER发生率 (5 8% )。 (2 ) 2 4h食管pH监测有助于了解哮喘患者的症状与GER的相关性。 (3 )对于有GER并与哮喘症状密切相关的患者 。
Objective To study the symptom correlation between gastroesophageal reflux (GER) and asthma, the significance of 24 hour esophageal pH monitoring in the diagnosis of GER and the efficacy of anti reflux therapy in asthmatics with GER Methods Twenty six patients with asthma , who presented with refractory respiratory symptoms despite of regular anti asthmatic treatment, were enrolled in the study 24 hour ambulatory esophageal pH monitoring was performed and symptoms,such as cough, chest tightness and pyrosis were recorded Peak expiratory flow (PEF) was performed hourly GER was defined by DeMeester score ≥14 72 or SAP (cough with reflux) ≥95% Patients with diagnosed GER were divided into two groups, one of which was given anti reflux therapy Results DeMeester score ≥14 72 was found in 58% (15/26) of the patients Symptom association probability (SAP) with cough ≥95% was found in 2 patients with a DeMeester score <14 72 Taken together,GER was diagnosed in 17 patients After anti reflux therapy, symptoms such as cough, chest tightness and pyrosis improved significantly, and the 24 hour PEF variability decreased significantly as compared to that before therapy [(38±8)% versus (16±3%, P <0 05] Conclusion The incidence of GER was 58% in this group of moderate to severe asthmatic patients 24 hour esophageal pH monitoring was of great value in diagnosing GER in asthmatic patients,and anti reflux therapy was effective in improving symptoms induced by GER in those patients
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2002年第12期739-743,共5页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
胃食管返流
哮喘
24小时食管PH监测
症状相关概率
Gastroesophageal reflux
Asthma
24 hour esophageal pH monitoring
Symptom association probability
