上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (9): 1070-.

• 论著（临床研究） • 上一篇    下一篇

胃食管反流病与慢性阻塞性肺病及其加重关系的探讨

胡家安1, 曹振英1, 徐志红1, 黄绍光2, 张伯膺3   

  1. 上海交通大学 医学院瑞金医院 1. 老年病科, 2. 呼吸科, 上海 200025；3. 卢湾分院呼吸科, 上海 200020
  • 出版日期:2009-09-25 发布日期:2009-09-29
  • 作者简介:胡家安（1961—）, 男, 主任医师, 学士；电子信箱: jahu_rj@yahoo.com.cn。
  • 基金资助:

    上海市科委重大研究项目（044119660）

Impact of gastroesophageal reflux disease to chronic obstructive pulmonary disease exacerbation

HU Jia-an1, CAO Zhen-ying1, XU Zhi-hong1, HUANG Shao-guang2, ZHANG Bo-ying3   

  1. 1. Department of Geriatrics, 2. Department of Respiratory Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China；3. Department of Respiratory Medicine, Luwan Branch of Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200020, China
  • Online:2009-09-25 Published:2009-09-29
  • Supported by:

    Major Foundamental Research Program of Shanghai Committee of Science and Technology, 044119660

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摘要：

目的 探讨胃食管反流病（GERD）与慢性阻塞性肺病（COPD）的关系，评估GERD对COPD急性加重的作用。方法 连续从门诊征集80例COPD患者，同时以61名非COPD成年男性吸烟者为对照组。所有研究对象完成反流性疾病诊断问卷（RDQ）、慢性黏液高分泌症（CMH）问卷和肺功能检查。一年后随访患者，确定一年内与医院相关的COPD急性加重发生率（急诊和住院治疗的次数）。结果 COPD组中GERD的发生率为18.8%，对照组为14.8%。气促程度严重的COPD 患者中GERD发生率高于气促程度轻的COPD患者（28.9% vs 17.1%）（P>0.05）。COPD组有CMH的患者23.8%表现GERD，而对照组有CMH者仅8.2%表现GERD（P<0.05）。有GERD与无GERD的COPD 患者，一年内有相似的COPD急性加重发生率，且医院相关的COPD急性加重和再入院的发生率亦相似。结论 GERD与COPD、COPD严重度和医院相关的COPD急性加重没有明显的关联。CMH与GERD之间具有显著相关性，提示CMH具有潜在作用，治疗有CMH的COPD患者时需要考虑GERD的影响。

关键词: 胃食管反流病, 慢性阻塞性肺病, 慢性黏液高分泌症, 发生率

Abstract:

Objective To explore relationship between gastroesophageal reflux disease (GERD) and chronic obstructive pulmonary disease (COPD) and to evaluate impact of GERD on COPD exacerbation. Methods A total of 80 COPD patients (COPD group) in the Outpatient Department and 61 non-COPD male smokers (control group) were recruited in this study. All people completed diagnostic questionnaires for GERD and chronic mucus hypersecretion (CMH) and lung function test. The rates of hospital related acute exacerbations of COPD (rehospitalization and visits in Department of Emergency) in the following one-year-long follow-up were obtained. Results GERD incidences were 18.5% and 14.8% in COPD and control groups, respectively. GERD incidence in COPD patients with severe dyspnea was higher than that in patients with slight dyspnea (28.9% vs 17.1%, P>0.05). GERD was observed in 23.8% of patients with CMH, while 8.2% in patients without CMH (P<0.05). COPD patients with GERD and without GERD had similar rates of exacerbation during the one-year follow-up period. The incidences of hospital-related acute exacerbation and re-hospitalization were similar in the two groups. Conclusion GERD is not associated with COPD, exacerbation, and hospital-related exacerbations of COPD. CMH is significantly correlated with GERD, which reveals the potential role of CMH and the consideration of GERD in treating COPD patients with CMH.

Key words: gastroesophageal reflux disease, chronic obstructive pulmonary diseases, chronic mucus hypersecretion, incidence rate

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