Palmer S M, Miralles A P, Howell D N, Brazer S R, Tapson V F, Davis R D
Department of Medicine, Duke University Medical Center, Durham NC, USA.
Chest. 2000 Oct;118(4):1214-7. doi: 10.1378/chest.118.4.1214.
Gastroesophageal reflux (GER) is increasingly recognized as contributing to a number of pulmonary disorders. The relationship of GER to pulmonary allograft dysfunction after lung transplantation is unknown. In this report, we describe a lung transplant recipient who developed an acute decline in pulmonary function several months after a retransplantation for chronic rejection. A pulmonary workup at that time, including bronchoscopy with biopsy, revealed bronchial inflammation with no allograft rejection or infection. Because of increasing GI symptoms after retransplantation, the patient also underwent additional testing, which revealed severe acid reflux. The treatment of this patient's acid reflux with Nissen fundoplication surgery resulted in a prompt and sustained improvement in his pulmonary function. We suggest that GER should be considered among the potential causes of allograft dysfunction after lung transplantation.
胃食管反流（GER）越来越被认为是导致多种肺部疾病的原因。GER与肺移植后肺移植功能障碍的关系尚不清楚。在本报告中，我们描述了一名肺移植受者，该患者在因慢性排斥反应进行再次移植数月后，肺功能急剧下降。当时的肺部检查，包括支气管镜检查及活检，显示有支气管炎症，但无移植肺排斥反应或感染。由于再次移植后胃肠道症状不断加重，该患者还接受了进一步检查，结果显示有严重的胃酸反流。采用nissen胃底折叠术治疗该患者的胃酸反流后，其肺功能迅速且持续改善。我们建议，在考虑肺移植后移植肺功能障碍的潜在原因时应想到GER。
