Internal Medicine Residency Program, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA.
Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA.
Medicina (Kaunas). 2023 Jul 8;59(7):1270. doi: 10.3390/medicina59071270.
Presenting chronic obstructive pulmonary disease (COPD) patients frequently report concurrent symptoms of gastroesophageal reflux disease (GERD). Few studies have shown a correlation between GERD and COPD. We aimed to examine the correlation between GERD and COPD as well as secondary related reflux complications, such as esophageal stricture, esophageal cancer, and Barrett's esophagus. : This population-based analysis included 7,159,694 patients. Patients diagnosed with GERD with and without COPD were compared to those without GERD. The enrollment of COPD included centrilobular and panlobular emphysema and chronic bronchitis. Risk factors of COPD or GERD were used for adjustment. Bivariate analyses were performed using the chi-squared test or Fisher exact test (2-tailed) for categorical variables as appropriate to assess the differences in the groups. : Our results showed that COPD patients had a significantly higher incidence of GERD compared to those without COPD (27.8% vs. 14.1%, < 0.01). After adjustment of demographics and risk factors, COPD patients had a 1.407 times higher risk of developing non-erosive esophagitis ( < 0.01), 1.165 higher risk of erosive esophagitis ( < 0.01), 1.399 times higher risk of esophageal stricture ( < 0.01), 1.354 times higher risk of Barrett's esophagus without dysplasia ( < 0.01), 1.327 times higher risk of Barrett's esophagus with dysplasia, as well as 1.235 times higher risk of esophageal cancer than those without COPD. : Based on the evidence from this study, there are sufficient data to provide convincing evidence of an association between COPD and GERD and its secondary reflux-related complications.
本研究旨在探讨 GERD 与 COPD 之间的相关性以及 GERD 的次级反流相关并发症（如食管狭窄、食管癌和 Barrett 食管）之间的相关性。该基于人群的分析纳入了 7159694 例患者。比较了患有和不患有 COPD 的 GERD 患者与不患有 GERD 的患者。COPD 的纳入标准包括小叶中央型和全小叶型肺气肿和慢性支气管炎。使用 COPD 或 GERD 的风险因素进行调整。使用卡方检验或 Fisher 确切检验（双侧）对分类变量进行双变量分析，以适当评估组间的差异。结果显示，与不患有 COPD 的患者相比，COPD 患者 GERD 的发生率显著更高（27.8% vs. 14.1%，<0.01）。在调整了人口统计学和危险因素后，COPD 患者发生非糜烂性食管炎的风险增加了 1.407 倍（<0.01），发生糜烂性食管炎的风险增加了 1.165 倍（<0.01），发生食管狭窄的风险增加了 1.399 倍（<0.01），发生无异型增生的 Barrett 食管的风险增加了 1.354 倍（<0.01），发生异型增生的 Barrett 食管的风险增加了 1.327 倍，发生食管癌的风险增加了 1.235 倍（<0.01）。基于本研究的证据，有足够的数据提供令人信服的证据证明 COPD 与 GERD 及其次级反流相关并发症之间存在关联。
