摘要
目的 探讨胃食管反流 (GER)性咳嗽的临床特征、诊断和治疗。方法 对 4 1例X线胸片、组胺激发试验、鼻部检查正常的慢性咳嗽患者进行 2 4h食管 pH监测 ,并利用症状相关性概率(SAP)来分析咳嗽与反流的相关性。对Demeester总积分≥ 14 72 ,和 (或 )咳嗽与反流SAP≥ 75 %者进行为期 12周的抗反流治疗。结果 4 1例患者中 ,有 2 6例诊断为GER性咳嗽 ,并给予抗反流治疗 ,完成疗程后 ,有 12例患者咳嗽完全消失 ,咳嗽与反流的SAP(上电极为 0 75± 0 2 1,下电极为0 91± 0 12 )显著高于另 14例对抗反流治疗反应较差或无效的患者 (上电极为 0 36± 0 31,下电极为 0 4 7± 0 30 ;P <0 0 5 )。结论 GER是不明原因慢性咳嗽的一个重要的独立原因。 2 4h食管 pH监测结合症状相关性分析有助于GER性咳嗽的诊断 ,抗反流治疗对其有较好的近期疗效。
Objective To investigate the clinical features, diagnosis and management of gastroesophageal reflux induced cough(GERC). Methods The continuous ambulatory esophageal pH measurement was performed for 24 hour in 41 cases with chronic cough who had normal chest roentgenographic presentation,negative histamine provocation test and no abnormality of nasal cavity. The symptom association probability (SAP) was adopted to analyze the correlation of cough with gastroesophageal reflux. The anti-reflux treatment was given for 12 weeks to those patients with Demeester score ≥14.72 and/or SAP≥75%. Results Twenty six out of 41 cases were diagnosed as patients with gastroesophageal reflux. The cough was completely cured in 12 cases after antireflux treatment. The SAP of cough in this cured group (proximal probe 0.75±0.21, distal probe 0.91±0.12, respectively) was significantly higher than that of patients who failed in response to antireflux treatment (proximal probe 0.36±0.31, distal probe 0.47±0.30, respectively, P <0.05). Conclusion The gastroesophageal reflux may be an independent factor which could induce chronic cough. Not only the frequency and severity of gastroesophageal reflux but also the SAP were helpful in making the diagnosis of GERC. Satisfied effect was achieved after sufficient anti-reflux treatment in patients with GERC.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2003年第7期461-465,共5页
Chinese Journal of Internal Medicine
基金
广州市科技攻关重点项目基金资助 (2 0 0 2Z2 E0 0 91)
