Al-Asoom Lubna, Al-Rubaish Abdullah M, El-Munshid Hassan A, Al-Nafaie Awatif N, Bukharie Huda A, Abdulrahman Ibrahim S
Department of Physiology, King Faisal University, Dammam, Kingdom of Saudi Arabia.
Saudi Med J. 2003 Dec;24(12):1364-9.
The objective is to correlate the symptoms of gastroesophageal reflux with the results of esophageal reflux with the results of esophageal pH metry in asthmatic patients.
A prospective study was carried out in King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia (KSA), during the period January 2000 through to February 2001, whereby 50 patients (34 females and 16 females) with primary diagnosis of bronchial asthma were consecutively enrolled, their mean age + SD was 38.01 + 9.8 years. Twenty-two subjects who were not suffering from asthma or gastroesophageal reflux (GER) (13 females and 9 males) constituted the control group. A questionnaire was administered to all participants and demographic data; asthma and GER symptoms were obtained. Esophageal manometry was performed, whereby the location, length and resting pressure of the lower esophageal sphincter (LES) were determined, pH catheter was inserted nasogastrically, and ambulatory pH data over 24 hours were collected. Pulmonary function tests were also performed.
Twenty-two (44%) patients with asthma had a Demeester score greater than 14.7 and were therefore diagnosed as having pathological GER. Accordingly, the asthma patients were divided into 2 groups, asthma patients with GER (n=22) and those without GER (n=28). Multiple logistic regression analysis revealed that age did not significantly influence occurrence of GER, but it indicated that hoarseness of voice and nocturnal symptoms were significant predictors for the presence of GER in asthmatic patients, hence, the probability of having GER in an asthma patient is nearly 8 times if he/she has nocturnal symptoms and about 7 times if they have hoarseness of voice. However 36.4% of asthmatic patients diagnosed by esophageal ph metry as having GER did not complain of heartburn and hoarseness of voice; such as the reflux was silent.
The frequency of GER among 50 patients with asthma reporting to KFHU, Al-Khobar, KSA is 44%. The presence of nocturnal symptoms and hoarseness of voice are significant clinical predictors of GER in asthmatic patients. Patients with difficult to treat asthma should be subjected to esophageal pH metry since a substantial proportion of them may have silent reflux.
目的是将哮喘患者的胃食管反流症状与食管反流结果及食管pH测定结果进行关联。
2000年1月至2001年2月期间，在沙特阿拉伯王国胡拜尔市法赫德国王大学医院进行了一项前瞻性研究，连续纳入50例初步诊断为支气管哮喘的患者（34例女性和16例男性），他们的平均年龄±标准差为38.01±9.8岁。22名未患哮喘或胃食管反流（GER）的受试者（13名女性和9名男性）组成对照组。对所有参与者进行问卷调查并获取人口统计学数据、哮喘和GER症状。进行食管测压，确定食管下括约肌（LES）的位置、长度和静息压力，经鼻插入pH导管，收集24小时动态pH数据。还进行肺功能测试。
22例（44%）哮喘患者的德梅斯特评分大于14.7，因此被诊断为病理性GER。据此，哮喘患者被分为两组，有GER的哮喘患者（n = 22）和无GER的哮喘患者（n = 28）。多因素逻辑回归分析显示，年龄对GER的发生没有显著影响，但表明声音嘶哑和夜间症状是哮喘患者存在GER的重要预测因素，因此，哮喘患者如果有夜间症状，患GER的概率几乎是8倍，如果有声音嘶哑则约为7倍。然而，经食管pH测定诊断为GER的哮喘患者中，36.4%没有烧心和声音嘶哑的主诉；即反流是无症状的。
向沙特阿拉伯王国胡拜尔市法赫德国王大学医院报告的50例哮喘患者中GER的发生率为44%。夜间症状和声音嘶哑的存在是哮喘患者GER的重要临床预测因素。难治性哮喘患者应进行食管pH测定，因为其中很大一部分可能有无症状反流。
