Gadel Abil Ali, Mostafa Mohamed, Younis Ahmed, Haleem Magdy
Mansura University, Egypt.
Hepatogastroenterology. 2012 Nov-Dec;59(120):2498-502. doi: 10.5754/hge10433.
BACKGROUND/AIMS: The association of esophageal motility and gastroesophageal reflux symptoms with respiratory symptoms is not well established in patients with chronic obstructive pulmonary disease (COPD). The aim of this work is to study the abnormalities of esophageal function in COPD patients and study its relation to smoking index, body mass index and indices of hyperinflation.
This study included 40 male COPD patients and 10 healthy controls. The patients and controls were subjected to spirometry, body plethysmography, esophageal manometry and 24hr pH-metry.
Upper gastrointestinal symptoms were found in 55% of patients, hypotensive upper esophageal sphincter pressure in 65% of patients and hypotensive lower esophageal sphincter pressure in 52.5% of patients. Pathological acid reflux was found in 35% of patients. The severity of GERD increased with increased age, smoking index and body mass index, p<0.005. There was negative correlation between LESP and UESP compared with indices of hyperinflation, p<0.001.
There was high prevalence of esophageal motility disorders in COPD patients, LESP and UESP were significantly negatively correlated to indices of hyperinflation. There was a high prevalence of GERD in COPD patents especially elderly, severe stage of COPD, high smoking index and high body mass index (BMI).
背景/目的:慢性阻塞性肺疾病(COPD)患者中,食管动力和胃食管反流症状与呼吸道症状之间的关联尚未明确。本研究旨在探讨COPD患者食管功能异常及其与吸烟指数、体重指数和肺过度充气指数的关系。
本研究纳入40例男性COPD患者和10例健康对照。对患者和对照进行肺功能测定、体容积描记法、食管测压和24小时pH监测。
55%的患者出现上消化道症状,65%的患者食管上括约肌压力降低,52.5%的患者食管下括约肌压力降低。35%的患者存在病理性酸反流。GERD的严重程度随年龄、吸烟指数和体重指数的增加而增加,p<0.005。与肺过度充气指数相比,LES P和UES P之间呈负相关,p<0.001。
COPD患者食管动力障碍患病率较高,LES P和UES P与肺过度充气指数显著负相关。COPD患者中GERD患病率较高,尤其是老年、COPD严重阶段、高吸烟指数和高体重指数(BMI)的患者。