Zhu Lixing, Ma Hongming, Zhong Nanshan
Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2002 Dec;25(12):739-43.
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.
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 > or = 14.72 or SAP (cough with reflux) > or = 95%. Patients with diagnosed GER were divided into two groups, one of which was given anti-reflux therapy.
DeMeester score > or = 14.72 was found in 58% (15/26) of the patients. Symptom association probability (SAP) with cough > or = 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].
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.
研究胃食管反流（GER）与哮喘之间的症状相关性、24小时食管pH监测在GER诊断中的意义以及抗反流治疗对合并GER的哮喘患者的疗效。
选取26例尽管接受了常规抗哮喘治疗但仍有难治性呼吸道症状的哮喘患者纳入研究。进行24小时动态食管pH监测，并记录咳嗽、胸闷和烧心等症状。每小时测量一次呼气峰值流速（PEF）。GER的定义为DeMeester评分≥14.72或症状关联概率（SAP，咳嗽伴反流）≥95%。确诊为GER的患者分为两组，其中一组给予抗反流治疗。
58%（15/26）的患者DeMeester评分≥14.72。2例DeMeester评分<14.72的患者症状关联概率（SAP）与咳嗽≥95%。综合来看，17例患者被诊断为GER。抗反流治疗后，咳嗽、胸闷和烧心等症状明显改善，与治疗前相比，24小时PEF变异性显著降低[（38±8）%对（16±3）%，P<0.05]。
该组中重度哮喘患者GER的发生率为58%。24小时食管pH监测对诊断哮喘患者的GER具有重要价值，抗反流治疗对改善这些患者中GER引起的症状有效。
