Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Respir Investig. 2024 Jul;62(4):599-605. doi: 10.1016/j.resinv.2024.04.017. Epub 2024 May 1.
The association between reflux esophagitis and pulmonary function remains controversial. Thus, evaluating the relationship between endoscopic reflux esophagitis and changes in pulmonary function over time in a nonsmoking population is an important clinical issue.
In this single-center retrospective cohort study, a medical examination database at Kameda Medical Center Makuhari was employed to identify nonsmokers who underwent upper gastrointestinal endoscopy and spirometry in 2010 and were followed up in 2015. Gastroenterologists carefully double-checked the diagnosis of reflux esophagitis. Multiple linear regression analyses were performed to compare the decline in the percentage of predicted vital capacity (%VC), forced vital capacity (%FVC), and forced expiratory volume in 1 s (%FEV) between participants with reflux esophagitis and those without. Furthermore, using multivariable logistic regression analyses, we evaluated the factors associated with rapid decline in %VC, %FVC, and %FEV, which is defined as a decrease of >10% in each parameter over the 5-year observation period.
We identified 3098 eligible subjects, including 72 and 44 participants who had a Los Angeles classification grade A and B-C (severe) reflux esophagitis in 2010, respectively. The decline in %VC was significantly larger in the participants with severe reflux esophagitis than in the control subjects (standardized coefficient, -0.037; 95% confidence interval, -0.071 to -0.004). Moreover, reflux esophagitis was significantly associated with a rapid decline in %VC and %FVC but not in %FEV (P for trend: 0.009, 0.009, and 0.276, respectively).
Severe reflux esophagitis among nonsmokers had clinical disadvantages in terms of a decline in %VC.
反流性食管炎与肺功能之间的关系仍存在争议。因此，评估非吸烟人群中内镜下反流性食管炎与随时间推移肺功能变化之间的关系是一个重要的临床问题。
在这项单中心回顾性队列研究中，我们使用镰仓 Kameda 医疗中心的体检数据库，确定了 2010 年接受上消化道内镜检查和肺功能检查且于 2015 年随访的非吸烟者。胃肠病学家仔细地对反流性食管炎的诊断进行了双重检查。采用多元线性回归分析比较了有反流性食管炎和无反流性食管炎的参与者之间预测肺活量百分比（%VC）、用力肺活量（%FVC）和 1 秒用力呼气量（%FEV）的下降情况。此外，我们使用多变量逻辑回归分析评估了与 %VC、%FVC 和 %FEV 快速下降相关的因素，这些参数在 5 年观察期间的下降幅度超过 10%。
我们确定了 3098 名合格的受试者，其中 2010 年洛杉矶分类 A 级和 B-C 级（严重）反流性食管炎患者分别有 72 名和 44 名。与对照组相比，严重反流性食管炎患者的 %VC 下降幅度更大（标准化系数，-0.037；95%置信区间，-0.071 至 -0.004）。此外，反流性食管炎与 %VC 和 %FVC 的快速下降显著相关，但与 %FEV 无关（趋势检验 P 值：0.009、0.009 和 0.276）。
在非吸烟者中，严重的反流性食管炎在 %VC 下降方面存在临床劣势。
