Hsu Jen-Yuan, Lien Han-Chung, Chang Chi-Sen, Chen Gran-Hum
Division of Chest Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
J Gastroenterol. 2005 Jan;40(1):11-5. doi: 10.1007/s00535-004-1489-4.
A high prevalence of gastroesophageal reflux disease (GERD) in asthmatic patients has been reported from North America and Europe. However, only a few data from Asia are available. This study evaluated the incidence of abnormal gastroesophageal reflux (GER) in asthmatic patients in Taiwan.
Fifty-six consecutive ambulatory patients with clinically stable asthma (41 men and 15 women; age, 57.7 +/- 12.4 years; range, 24 to 74 years) were evaluated prospectively. All patients underwent esophagogastroduodenoscopy, esophageal manometry, and 24-h esophageal pH monitoring.
Twenty-nine patients (51.8%) had abnormal GER, as defined by 24-h esophageal pH monitoring. There were 42 patients without endoscopic evidence of esophagitis, 10 patients with Los Angeles (LA) grade A esophagitis, and 4 patients with LA grade B esophagitis. The esophageal motility function studies revealed 21 patients with normal esophageal motility, 23 patients with ineffective esophageal motility (IEM), and 12 patients with nonspecific esophageal motility disorders other than IEM. Although the lower esophageal sphincter (LES) basal pressure was higher in the patients without GER, the difference was not statistically significant.
Abnormal GER seems to be a clinically significant problem in asthmatic patients in Taiwan. The most common esophageal motility dysfunction is IEM. However, the status of Helicobacter pylori infection plays no role in abnormal GER.
北美和欧洲已有报道称哮喘患者中胃食管反流病(GERD)的患病率较高。然而,亚洲仅有少量相关数据。本研究评估了台湾哮喘患者中胃食管反流(GER)异常的发生率。
对56例临床病情稳定的门诊哮喘患者(41例男性和15例女性;年龄57.7±12.4岁;范围24至74岁)进行前瞻性评估。所有患者均接受了食管胃十二指肠镜检查、食管测压和24小时食管pH监测。
根据24小时食管pH监测定义,29例患者(51.8%)存在GER异常。42例患者无食管炎的内镜证据,10例患者为洛杉矶(LA)A级食管炎,4例患者为LA B级食管炎。食管动力功能研究显示,21例患者食管动力正常,23例患者存在无效食管动力(IEM),12例患者存在除IEM外的非特异性食管动力障碍。虽然无GER患者的食管下括约肌(LES)基础压力较高,但差异无统计学意义。
GER异常似乎是台湾哮喘患者的一个具有临床意义的问题。最常见的食管动力功能障碍是IEM。然而,幽门螺杆菌感染状况在GER异常中不起作用。