Benson Victoria S, Müllerová Hana, Vestbo Jørgen, Wedzicha Jadwiga A, Patel Anant, Hurst John R
Respiratory Epidemiology, GSK R&D, Uxbridge, United Kingdom.
Centre for Respiratory and Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital South Manchester NHS Foundation Trust, Manchester, United Kingdom.
Respir Med. 2015 Sep;109(9):1147-54. doi: 10.1016/j.rmed.2015.06.009. Epub 2015 Jun 23.
To determine factors, overall and by sex, associated with self-reported gastro-oesophageal reflux disease (GORD) in chronic obstructive pulmonary disease (COPD) patients, and to evaluate relationships between GORD, its modification by acid suppression medications (Proton Pump Inhibitors [PPI]/histamine-2 receptor antagonists [H2RA]) and exacerbations of COPD and mortality.
Logistic regression was used to determine factors associated with GORD; Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for GORD and risk of exacerbation and death.
Among 2135 COPD patients from the ECLIPSE cohort, 547 patients self-reported GORD, with female preponderance; 237 were taking PPI/H2RA. Risk factors for GORD did not differ by sex. When compared to patients who did not report GORD or use of PPI/H2RA, patients with GORD and taking PPI/H2RA had a significantly increased risk of exacerbation (HR = 1.58, 95%CI = 1.35-1.86); risk was also increased for patients reporting GORD only or PPI/H2RA use only (HR = 1.21 [1.04-1.40] and 1.33 [1.08-1.65], respectively). Similar findings were observed for risk of hospitalised exacerbation. GORD was not associated with mortality.
GORD in COPD patients is highly prevalent, and risk factors did not differ by sex. Use of PPI/H2RA and self-reported GORD were associated with increased risk of moderate-to-severe and hospitalised exacerbations.
确定慢性阻塞性肺疾病（COPD）患者中与自我报告的胃食管反流病（GORD）相关的总体因素及按性别划分的因素，并评估GORD、其通过抑酸药物（质子泵抑制剂[PPI]/组胺-2受体拮抗剂[H2RA]）的改善情况与COPD急性加重和死亡率之间的关系。
采用逻辑回归确定与GORD相关的因素；使用Cox比例风险模型计算GORD、急性加重风险和死亡风险的调整后风险比（HR）及95%置信区间（CI）。
在ECLIPSE队列的2135例COPD患者中，547例患者自我报告患有GORD，女性居多；237例正在服用PPI/H2RA。GORD的危险因素在性别上无差异。与未报告GORD或未使用PPI/H2RA的患者相比，患有GORD且正在服用PPI/H2RA的患者急性加重风险显著增加（HR = 1.58，95%CI = 1.35 - 1.86）；仅报告GORD或仅使用PPI/H2RA的患者风险也增加（分别为HR = 1.21[1.04 - 1.40]和1.33[1.08 - 1.65]）。住院急性加重风险也有类似发现。GORD与死亡率无关。
COPD患者中GORD非常普遍，且危险因素在性别上无差异。使用PPI/H2RA和自我报告的GORD与中重度及住院急性加重风险增加相关。
