胃食管返流病并支气管哮喘17例临床分析.docVIP

胃食管返流病并支气管哮喘17例临床分析 【摘要】 目的：探讨胃食管返流(GER)与哮喘的关系。方法：对17例以哮喘为主要表现的胃食管返流病(GERD)患者进行食管24 h pH值监测及胃镜检查并进行抗返流治疗，以19例无呼吸系统症状的GERD患者作为对照。结果：以哮喘为主要表现的GERD患者食管24 h pH监测的各项指标与对照组比较差异有显著性，胃镜结果差异无显著性，抗返流治疗对哮喘治疗有效，提示哮喘症状与酸返流密切相关。结论：胃食管返流病并哮喘症状的患者酸返流比普通GERD患者重；24 h食管pH监测有助于了解哮喘患者的症状与GER的相关性；对有GER并哮喘症状的患者，抗返流治疗可显著改善其症状。 【关键词】 胃食管返流 哮喘 24 h食管pH监测 　　Clinical Analysis of 17 Cases GERD Combined Asthma 　 Abstract: Objective To study the symptom correlation between gastroesophageal reflux (GER) and asthma. Methods 24 hour Esophageal pH monitoring and the gastroscopy were performed in 17 GERD patients who had the main clinical symptom of asthma,and the relationship between the clinical symptom of respiratory system and GERD was analyzed, and was given antireflux therapy. There are 19 GERD patients who did not have the clinical symptom of respiratory system as the control. Results The date from 24 hour pH inspection showed the GERD patients who had the clinical symptom of respiratory system are higher than those who did not (Plt;0.05).the symptom of asthma were closely associated with esophageal acid exposure, and the result of the gastroscopy did not have notable difference. And antireflux therapy was effective in improving symptoms of asthma induced by GER. Conclusion The GERD patients with asthma have more esophageal acid exposure than the control patients;24 hour esophageal pH monitoring was of great value in diagnosing GER in asthmatic patients and antireflux therapy was effective in those patients. Key words: Gastroesophageal reflux; Asthma; 24 hour Esophageal pH monitoring 胃食管返流病(Gastroesophageal reflux disease,GERD)是消化系统常见病，主要表现为反酸、烧心、胸痛等不适，但部分患者以咳嗽、哮喘等呼吸系统症状为主要表现甚至是唯一临床表现时，常影响临床诊断，易出现误诊，本文回顾2001年2月至2005年2月确诊的17例以哮喘为主要表现的GERD患者的临床资料，并将其与以消化道表现为主的GERD进行比较，探讨其特点。 　　1 资料与方法 　　1.1 病例选择及分组 　　观察组17例，男10例，女7例，平均年龄（38±15）岁，均符合中华医学会呼吸病学分会哮喘学组支气管哮喘诊断标准［1］，分级为中—重度。病例入选条件：经规范支气管哮喘治疗，包括吸入糖皮质激素、茶碱及β2受体激动剂（按需）等，仍不能控制的咳嗽、胸闷、哮喘等症状者。但排除孕妇、年龄≤15岁者