Harmanci E, Entok E, Metintas M, Vardareli E, Elbek O
Departments of Pulmonary Diseases, Osmangazi University School of Medicine Eskisehir, Turkey.
Allergol Immunopathol (Madr). 2001 Jul-Aug;29(4):123-8. doi: 10.1016/s0301-0546(01)79044-1.
Thirty one patients with asthma (mean age was 44.4 10.7; range 18-63) were investigated for gastroesophageal reflux (GER). The patients were separated into two groups according to presence of reflux and/or nocturnal symptoms. 13 patients had one of the reflux and/or nocturnal asthma symptoms (Group 1), whereas 18 patients had none of them (Group 2). To assess GER patients underwent to scintigraphy with Tc99m. GER was determined 4 of 13 patients in group 1 (30,7 %) and 1 of 18 patients in group 2 (5,5 %). There was significant difference between the group 1 and group 2 in that respect (p < 0,001). The patients with established GER (5 patients) were given Omeprazole (a proton pomp inhibitor) 40 mg daily for 4 weeks following a 2 week placebo period. The patients recorded their daily and nocturnal symptoms of asthma, additional salbutamol use, morning and evening peak expiratory flow rates (PEFR) measurements in a daily chart during placebo and omeprazole treatment without changing their antiasthma treatment. Their PEFR, FEV1 values, daily and nocturnal symptoms and additional beta agonist use did not changed after omeprazole treatment except one. But their reflux symptoms (heartburn and regurgitation) were improved. As a consequence, we suggested that asthmatics which have some complaints of reflux should be searched for GER. Not the respiratory functions but GER symptoms can be improved w
对31例哮喘患者(平均年龄44.4±10.7岁;范围18 - 63岁)进行了胃食管反流(GER)调查。根据是否存在反流和/或夜间症状将患者分为两组。13例患者有反流和/或夜间哮喘症状之一(第1组),而18例患者没有这些症状(第2组)。为评估GER,患者接受了99m锝闪烁扫描。第1组13例患者中有4例(30.7%)检测到GER,第2组18例患者中有1例(5.5%)检测到GER。在这方面,第1组和第2组之间存在显著差异(p < 0.001)。确诊为GER的患者(5例)在经过2周安慰剂期后,每天给予40毫克奥美拉唑(一种质子泵抑制剂),持续4周。患者在安慰剂和奥美拉唑治疗期间,在每日图表中记录哮喘的每日和夜间症状、额外使用沙丁胺醇的情况、早晚呼气峰值流速(PEFR)测量值,且不改变其抗哮喘治疗。除1例患者外,奥美拉唑治疗后他们的PEFR、FEV1值、每日和夜间症状以及额外使用β受体激动剂的情况均未改变。但他们的反流症状(烧心和反流)有所改善。因此,我们建议对有反流症状的哮喘患者进行GER检查。不是呼吸功能而是GER症状可以得到改善。