Simpson W G
Department of Medicine, University of Kentucky, Lexington, USA.
Arch Intern Med. 1995 Apr 24;155(8):798-803.
Gastroesophageal reflux is common among asthmatics. It not only may worsen during an episode of airways obstruction but also may serve as a trigger for such an attack. Both animal and clinical data suggest that gastroesophageal reflux serves as a trigger of bronchospasm, potentiates the bronchomotor response to additional triggers, or both. Patients with reflux-associated asthma may manifest symptoms of gastroesophageal reflux, either classic or atypical, but approximately 25% to 30% have clinically silent reflux. Despite the use of inadequate doses of acid-suppressive medicines, clinical trials have documented improvement in respiratory symptoms among asthmatics following the treatment of reflux. Recent trials suggest long-term improvement in respiratory symptoms following antireflux surgery. Selected patients with asthma should be evaluated for gastroesophageal reflux. If it is present, such patients may benefit from aggressive antireflux therapy.
胃食管反流在哮喘患者中很常见。它不仅可能在气道阻塞发作期间加重，还可能引发此类发作。动物和临床数据均表明，胃食管反流是支气管痉挛的触发因素，可增强支气管对其他触发因素的运动反应，或两者兼而有之。反流相关性哮喘患者可能表现出典型或非典型的胃食管反流症状，但约25%至30%的患者存在临床无症状的反流。尽管使用了剂量不足的抑酸药物，但临床试验已证明，哮喘患者在反流治疗后呼吸道症状有所改善。最近的试验表明，抗反流手术后呼吸道症状可长期改善。部分哮喘患者应评估是否存在胃食管反流。如果存在，此类患者可能会从积极的抗反流治疗中获益。
