Department of Medicine, Maulana Azad Medical College Department of Biosciences, Jamia Millia Islamia, New Delhi, India.
Respirology. 2013 Apr;18(3):463-7. doi: 10.1111/j.1440-1843.2012.02285.x.
To study the incidence and pattern of gastro-oesophageal reflux disease (GORD) in patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) using dual-probe 24-h oesophageal pH recording.
This was a prospective study of 50 patients with mild-to-moderate stage COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. A detailed history of illness along with spirometry was done in all patients. In the study group, reflux symptoms were measured using a validated scoring system. All the patients underwent oesophageal manometry and dual-probe 24-h oesophageal pH recording.
Symptoms of gastro-oesophageal reflux were present in 38 patients. Twenty-four-hour oesophageal pH monitoring revealed pathological reflux in 31 out of 38 symptomatic and 8 out of 12 asymptomatic patients. The overall rate of GORD was 78% in our study. Only distal GORD was observed in 11 (28.9%), and both distal and proximal GORD was observed in 20 (52.6%) out of the 38 symptomatic subjects. In the remaining 12 asymptomatic patients, eight had GORD. Distal GORD was present in six (50%) patients, and two (16.6%) had both distal and proximal GORD in this group. Isolated proximal GORD was not observed in any patient.
There is an increased occurrence of GORD in patients with even mild-to-moderate COPD.
采用双探头 24 小时食管 pH 监测研究轻度至中度慢性阻塞性肺疾病(COPD)患者胃食管反流病(GORD)的发生率和模式。
这是一项基于全球慢性阻塞性肺疾病倡议(GOLD)指南的 50 例轻度至中度 COPD 患者的前瞻性研究。所有患者均进行详细的病史和肺功能检查。在研究组中,使用经过验证的评分系统来测量反流症状。所有患者均进行食管测压和双探头 24 小时食管 pH 监测。
38 例患者存在胃食管反流症状。24 小时食管 pH 监测显示,38 例有症状患者中有 31 例和 12 例无症状患者中有 8 例存在病理性反流。本研究中 GORD 的总体发生率为 78%。仅观察到 11 例(28.9%)远端 GORD,20 例(52.6%)有症状患者观察到远端和近端 GORD。在其余 12 例无症状患者中,有 8 例存在 GORD。其中 6 例(50%)存在远端 GORD,2 例(16.6%)存在远端和近端 GORD。在任何患者中均未观察到单纯近端 GORD。
即使是轻度至中度 COPD 患者,GORD 的发生率也会增加。