Ferrari M, Bonella F, Benini L, Ferrari P, De Iorio F, Testi R, Lo Cascio V
Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy.
Br J Sports Med. 2008 Oct;42(10):845-9; discussion 849-50. doi: 10.1136/bjsm.2006.034983. Epub 2007 Jun 1.
A few studies on small patient series have investigated the relationship between gastroesophageal reflux and bronchial responsiveness as expressed by exercise-induced bronchoconstriction (EIB), with non-conclusive results. The aim of this study was to evaluate whether the presence of acid in the oesophagus may influence EIB.
45 patients with bronchial asthma underwent spirometry, exercise challenge on bicycle ergometer and 24 h oesophageal pH monitoring. Subjects with EIB (Forced expiratory volume in the first second (FEV1)) percentage decrease after exercise (DeltaFEV1) > or =15%, n = 28) were retested after a 2 week treatment course with omeprazole 40 mg/daily. Exercise at baseline was performed at the same time as oesophageal pH monitoring.
In basal condition, there was no difference in FEV1, acid exposure time or number of refluxes measured during 24 h pH monitoring between patients with and without EIB. There was no relationship between spirometry results and DeltaFEV1 on one hand, and parameters of gastroesophageal reflux on the other. Nine patients with EIB (31.0%) and six patients without EIB (37.5%) had one or more episodes of GER during exercise challenge, without significant differences between the two groups. After gastric acid inhibition by omeprazole, DeltaFEV1 did not change significantly.
The results indicate that acid in the oesophagus, or its short-term inhibition by proton pump inhibitors, has no influence on exercise-induced bronchoconstriction.
少数针对小样本患者的研究探讨了胃食管反流与运动诱发性支气管收缩（EIB）所表达的支气管反应性之间的关系，但结果尚无定论。本研究的目的是评估食管内酸的存在是否会影响EIB。
45例支气管哮喘患者接受了肺活量测定、自行车测力计运动激发试验和24小时食管pH监测。对运动诱发性支气管收缩（第一秒用力呼气量（FEV1）运动后百分比下降（ΔFEV1）≥15%，n = 28）的受试者，在接受为期2周的每日40 mg奥美拉唑治疗后重新进行检测。基线运动与食管pH监测同时进行。
在基础状态下，有或无运动诱发性支气管收缩的患者在24小时pH监测期间测得的FEV1、酸暴露时间或反流次数无差异。一方面，肺活量测定结果与ΔFEV1之间，另一方面，与胃食管反流参数之间均无关系。9例运动诱发性支气管收缩患者（31.0%）和6例无运动诱发性支气管收缩患者（37.5%）在运动激发试验期间有一次或多次胃食管反流发作，两组之间无显著差异。在使用奥美拉唑抑制胃酸后，ΔFEV1无显著变化。
结果表明，食管内的酸或质子泵抑制剂对其的短期抑制，对运动诱发性支气管收缩没有影响。
