Peters F T, Kleibeuker J H, Postma D S
Dept. of Gastroenterology, University Hospital Groningen, The Netherlands.
Scand J Gastroenterol Suppl. 1998;225:19-23. doi: 10.1080/003655298750027164.
Gastro-oesophageal reflux disease (GORD) is manifested by typical reflux symptoms and atypical extra-oesophageal symptoms. Important in this respect are respiratory conditions. Gastric asthma is a prominent example of these extra-oesophageal manifestations of GORD. There is, however, much debate about its prevalence, pathophysiology and clinical importance.
Narrative review of the literature.
In asthmatics, the prevalence of GORD is generally reported to be higher than in normals, but with a wide range, probably due to patient selection. In a minority of asthmatics GORD aggravates or triggers asthma. The pathogenetic mechanisms can be a vagally transmitted reflex as well as micro-aspiration of refluxed material. The association with inflammatory mediator release has been insufficiently investigated. Selecting those who are likely to respond to anti-reflux measures is important: those with difficult to treat asthma, non-allergic asthma, adult-onset asthma with GORD. Oesophageal pH-metry to prove GORD and gastroscopy to diagnose Barrett's metaplasia are advisable.
胃食管反流病（GORD）表现为典型的反流症状和非典型的食管外症状。在这方面，呼吸状况很重要。胃性哮喘是GORD这些食管外表现的一个突出例子。然而，关于其患病率、病理生理学和临床重要性存在很多争议。
对文献进行叙述性综述。
在哮喘患者中，一般报道GORD的患病率高于正常人，但范围很广，这可能是由于患者选择的原因。在少数哮喘患者中，GORD会加重或引发哮喘。发病机制可能是迷走神经传导反射以及反流物质的微量误吸。与炎症介质释放的关联研究不足。选择可能对抗反流措施有反应的患者很重要：那些哮喘难以治疗、非过敏性哮喘、伴有GORD的成人起病型哮喘患者。建议采用食管pH监测来证实GORD，并通过胃镜检查来诊断巴雷特化生。
