Chan Walter W, Sharma Nirmal, Gyawali C Prakash
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Am J Gastroenterol. 2025 Jan 1;120(1):60-64. doi: 10.14309/ajg.0000000000003205. Epub 2024 Nov 14.
Gastroesophageal reflux disease occurs when the barrier at the esophagogastric junction is weakened, allowing for transient relaxations of the lower esophageal sphincter or disruption of the esophagogastric junction. This leads to the refluxate traveling up the esophagus, and potentially into the pharynx, where it can be aspirated into the airway. The refluxate can cause a range of symptoms, including sore throat, coughing, wheezing, and shortness of breath, which may occur with or without visible airway inflammation. Both experimental and clinical studies have shown that aspirated refluxate can directly damage the airway lining and trigger immune responses that contribute to airway injury and inflammation. While traditional diagnostic tests for gastroesophageal reflux disease can identify abnormal reflux patterns, there is a need for more specific methods to predict airway inflammation or therapeutic outcomes related to reflux aspiration.
当食管胃交界处的屏障被削弱时,就会发生胃食管反流病,这会导致食管下括约肌出现短暂松弛或食管胃交界处遭到破坏。这会使反流物向上进入食管,并有可能进入咽部,进而被吸入气道。反流物会引发一系列症状,包括喉咙痛、咳嗽、喘息和呼吸急促,这些症状可能伴有或不伴有明显的气道炎症。实验研究和临床研究均表明,被吸入的反流物会直接损害气道黏膜,并引发免疫反应,进而导致气道损伤和炎症。虽然传统的胃食管反流病诊断测试能够识别异常的反流模式,但仍需要更具特异性的方法来预测与反流物吸入相关的气道炎症或治疗效果。