Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China.
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Front Med. 2017 Mar;11(1):68-73. doi: 10.1007/s11684-016-0490-7. Epub 2017 Mar 2.
This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery.Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5 ± 1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61 ± 0.77 pre-procedure to 1.27 ± 0.88 post-procedure (P < 0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1 ± 1.0 preprocedure to 1.4 ± 1.0 post-procedure (P < 0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.
本研究旨在探讨胃食管反流病（GERD）患者成功接受腹腔镜胃底折叠术（laparoscopic fundoplication）治疗后，是否能改善高血压的控制情况。我们进行了一项观察性研究，纳入了合并高血压的 GERD 患者。通过 GERD 症状评分（GERD symptoms score）和质子泵抑制剂（proton pump inhibitor）消耗量评估，腹腔镜胃底折叠术成功缓解了这些患者的食管和胃食管症状。采用高血压控制量表（hypertension control scale）评估抗反流手术后降压药物的使用情况和血压控制质量。采用 Wilcoxon 符号秩检验进行统计学分析。共纳入 70 例 GERD 患者，平均随访 3.5 ± 1.4 年。所有入组患者术前均至少使用 1 种降压药物，56 例（80%）患者存在间歇性高血压。术后，患者平均降压药物种类从术前的 1.61 ± 0.77 种减少至 1.27 ± 0.88 种（P < 0.001）。术前存在间歇性高血压的 56 例患者中，48 例（86%）的血压恢复正常。高血压控制量表评分改善的患者共 50 例（71%），总评分从术前的 3.1 ± 1.0 降至术后的 1.4 ± 1.0（P < 0.001）。因此，腹腔镜胃底折叠术治疗可能使部分高血压合并 GERD 患者的血压控制更好。这一结果提示胃食管反流与高血压之间可能存在关联。
