Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
J Korean Med Sci. 2021 Feb 1;36(5):e29. doi: 10.3346/jkms.2021.36.e29.
The impact of reflux esophagitis on the decline of lung function has been rarely reported. This study was performed to evaluate the association between erosive reflux esophagitis and lung function changes.
We included patients with normal lung function who underwent esophagogastroduodenoscopy for health screening from a health screening center. Patients with persistent erosive reflux esophagitis on two discrete endoscopic examinations were designated as the erosive reflux esophagitis group. We also selected patients without erosive reflux esophagitis and matched them 1:4 with patients from the erosive reflux esophagitis group. We estimated annual forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) changes from baseline and compared these estimates by the linear mixed regression model. We also estimated the biannual incidence of chronic obstructive pulmonary disease (COPD).
In total, 1,050 patients (210 patients with erosive reflux esophagitis, and 840 matched controls) were included. The median follow-up duration for spirometry was six years. In patients with erosive reflux esophagitis, mild reflux esophagitis (A grade) was most common (165 patients, 78.6%). The adjusted annual FEV₁ change in patients with erosive reflux esophagitis was -51.8 mL/yr, while it decreased by 46.8 mL/yr in controls ( = 0.270). The adjusted annual FVC decline was similar between the two groups (-55.8 vs. -50.5 mL/yr, = 0.215). The estimated COPD incidence during the follow-up period was not different between the erosive reflux esophagitis and control groups.
In patients with normal lung function, the presence of erosive reflux esophagitis did not affect the annual declines in FEV₁ or FVC.
反流性食管炎对肺功能下降的影响鲜有报道。本研究旨在评估糜烂性反流性食管炎与肺功能变化的关系。
我们纳入了因健康筛查在健康筛查中心行食管胃十二指肠镜检查的肺功能正常的患者。两次内镜检查均存在持续性糜烂性反流性食管炎的患者被指定为糜烂性反流性食管炎组。我们还选择了无糜烂性反流性食管炎的患者，并按照 1:4 的比例与糜烂性反流性食管炎组的患者进行匹配。我们估计了从基线开始的每年用力呼气量（FEV₁）和用力肺活量（FVC）的变化，并通过线性混合回归模型比较了这些估计值。我们还估计了慢性阻塞性肺疾病（COPD）的两年发病率。
共纳入 1050 例患者（210 例糜烂性反流性食管炎患者和 840 例匹配对照）。肺功能检查的中位随访时间为 6 年。在糜烂性反流性食管炎患者中，最常见的是轻度反流性食管炎（A级）（165 例，78.6%）。糜烂性反流性食管炎患者的调整后每年 FEV₁变化为-51.8 mL/yr，而对照组为-46.8 mL/yr（ = 0.270）。两组的调整后每年 FVC 下降相似（-55.8 与-50.5 mL/yr， = 0.215）。在随访期间，估计的 COPD 发病率在糜烂性反流性食管炎组和对照组之间没有差异。
在肺功能正常的患者中，糜烂性反流性食管炎的存在并不影响 FEV₁或 FVC 的年下降率。
