Aras Gulfidan, Kanmaz Dilek, Kadakal Figen, Purisa Sevim, Sonmez Kenan, Tuncay Esin, Ozdemir Arzu
Yedikule Chest Disease and Surgery Education and Research Hospital, Istanbul, Turkey.
Multidiscip Respir Med. 2012 Dec 17;7(1):53. doi: 10.1186/2049-6958-7-53.
The prevalence of Gastroesophageal Reflux Disease (GERD) in Turkey is reported as 11.6%. Studies of pulmonary function in asthmatics have demonstrated a correlation between lung resistance and the occurrence of spontaneous gastroesophageal reflux. Few studies have included measures of lung diffusing capacity for carbon monoxide. The aim of this study is to assess whether asthma patients had worse lung function and gas diffusion according to diversity of GERD symptoms they concurrently experienced. The secondary aim of the study is to determine the frequency and different faces of GERD in our asthma patients compared to healthy controls.
Sixty consecutive asthma patients evaluatd at the pulmonary specialty outpatient clinic were included in the study. The control group included 60 healthy volunteers who had normal pulmonary function and routine laboratory tests. A modified version of a self-reported questionnaire developed by Locke and associates at the Mayo Clinic was conducted face-to-face with consecutive asthma patients and control subjects. Pulmonary function measurements were taken using spirometry. DLCO (mL/dk/mmHg) and DLCO/VA (DLCO adjusted according to alveolar volume) were measured using a single-breath technique. Statistical analyses were performed using the SPSS 17.0 statistical software.
DLCO and DLCO/VA were significantly lower in asthma patients who had dysphagia symptoms. Frequent and significant acid regurgitations were seen in 28.33% (n = 17) of patients in the study group and 6.7% (n = 4) of patients in the control group. Severe, troublesome heartburn symptoms were reported by 28.2% (n = 17) of patients in the study group and 16.7% (n = 10) of subjects in the control group. Dysphagia was detected in 38.3% (n = 23) of all asthma cases and in 1.7% (n = 1) of the subjects in the control group.
There were many faces of gastroesophageal reflux disease in our asthmatic patients. Dysphagia was the only GERD symptom influencing on pulmonary function tests, while gastroesophageal reflux symptoms and nocturnal awakening attacks were common in this study.
据报道，土耳其胃食管反流病（GERD）的患病率为11.6%。对哮喘患者肺功能的研究表明，肺阻力与自发性胃食管反流的发生之间存在相关性。很少有研究纳入一氧化碳肺弥散量的测量。本研究的目的是根据哮喘患者同时经历的GERD症状的多样性，评估其肺功能和气体扩散是否更差。该研究的次要目的是确定与健康对照组相比，我们的哮喘患者中GERD的频率和不同表现。
本研究纳入了在肺科专科门诊连续评估的60例哮喘患者。对照组包括60名肺功能和常规实验室检查正常的健康志愿者。由梅奥诊所的洛克及其同事开发的一份自我报告问卷的修改版，与连续的哮喘患者和对照受试者进行了面对面调查。使用肺量计进行肺功能测量。采用单次呼吸技术测量一氧化碳弥散量（DLCO，mL/dk/mmHg）和一氧化碳弥散量/肺泡容积（根据肺泡容积调整的DLCO）。使用SPSS 17.0统计软件进行统计分析。
有吞咽困难症状的哮喘患者的DLCO和DLCO/VA显著降低。研究组28.33%（n = 17）的患者和对照组6.7%（n = 4）的患者出现频繁且显著的反酸。研究组28.2%（n = 17）的患者和对照组16.7%（n = 10）的受试者报告有严重的、令人困扰的烧心症状。在所有哮喘病例中，38.3%（n = 23）的患者检测到吞咽困难，而对照组中1.7%（n = 1）的受试者检测到吞咽困难。
我们的哮喘患者中胃食管反流病有多种表现。吞咽困难是唯一影响肺功能测试的GERD症状，而胃食管反流症状和夜间觉醒发作在本研究中很常见。
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