胃食管反流与慢性呼吸疾病
2017/10/09
摘要
胃食管反流病（GERD）的发生与慢性呼吸疾病相关，但其中的因果关系至今仍不明确。呼吸疾病的多个病理生理学改变及实验因素提示GERD可以导致慢性呼吸疾病。相反，呼吸系统疾病及支气管扩张剂治疗本身也可以加重GERD。当研究咳嗽或重症哮喘时，无需系统性地查找GERD，且此时不一定推荐应用质子泵抑制剂治疗。PH阻抗监测可作为非胃酸反流型---即应用质子泵抑制剂治疗无效的反流型GERD的参考诊断方法。近期研究结果显示GERD 在肺移植术后的特发性肺纤维化及闭塞性细支气管炎的发生发展中具有潜在作用，启发了研究者关于手术部位的思考。然而，若要更好地理解与处理GERD与慢性呼吸疾病的联系，PH阻抗监测在研究中的应用十分有必要。
Gastro-esophageal reflux and chronic respiratory diseases.
Dirou S, Germaud P, Bruley des Varannes S, Magnan A, Blanc FX.
Abstract
Gastroesophageal reflux disease (GERD) frequently occurs in association with chronic respiratory diseases although the casual link is not always clear. Several pathophysiological and experimental factors are considered to support a role for GERD in respiratory disease. Conversely, respiratory diseases and bronchodilator treatment can themselves exacerbate GERD. When cough or severe asthma is being investigated, GERD does not need to be systematically looked for and a therapeutic test with proton pump inhibitors is not always recommended. pH impedance monitoring is now the reference diagnostic tool to detect non acid reflux, a form of reflux for which proton pump inhibitor treatment is ineffective. Recent data have shown a potential role of GERD in idiopathic pulmonary fibrosis and bronchiolitis obliterans following lung transplantation, leading to discussions about the place of surgery in this context. However, studies using pH impedance monitoring are still needed to better understand and manage the association between GERD and chronic respiratory diseases.
胃食管反流病（GERD）的发生与慢性呼吸疾病相关，但其中的因果关系至今仍不明确。呼吸疾病的多个病理生理学改变及实验因素提示GERD可以导致慢性呼吸疾病。相反，呼吸系统疾病及支气管扩张剂治疗本身也可以加重GERD。当研究咳嗽或重症哮喘时，无需系统性地查找GERD，且此时不一定推荐应用质子泵抑制剂治疗。PH阻抗监测可作为非胃酸反流型---即应用质子泵抑制剂治疗无效的反流型GERD的参考诊断方法。近期研究结果显示GERD 在肺移植术后的特发性肺纤维化及闭塞性细支气管炎的发生发展中具有潜在作用，启发了研究者关于手术部位的思考。然而，若要更好地理解与处理GERD与慢性呼吸疾病的联系，PH阻抗监测在研究中的应用十分有必要。
（中国医科大学附属一院呼吸与危重症学科 李文扬 摘译 杨 冬 审校）
（Rev Mal Respir. 2015 Dec;32(10):1034-46.）
（Rev Mal Respir. 2015 Dec;32(10):1034-46.）
Gastro-esophageal reflux and chronic respiratory diseases.
Dirou S, Germaud P, Bruley des Varannes S, Magnan A, Blanc FX.
Abstract
Gastroesophageal reflux disease (GERD) frequently occurs in association with chronic respiratory diseases although the casual link is not always clear. Several pathophysiological and experimental factors are considered to support a role for GERD in respiratory disease. Conversely, respiratory diseases and bronchodilator treatment can themselves exacerbate GERD. When cough or severe asthma is being investigated, GERD does not need to be systematically looked for and a therapeutic test with proton pump inhibitors is not always recommended. pH impedance monitoring is now the reference diagnostic tool to detect non acid reflux, a form of reflux for which proton pump inhibitor treatment is ineffective. Recent data have shown a potential role of GERD in idiopathic pulmonary fibrosis and bronchiolitis obliterans following lung transplantation, leading to discussions about the place of surgery in this context. However, studies using pH impedance monitoring are still needed to better understand and manage the association between GERD and chronic respiratory diseases.
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在亚洲睡眠诊所转诊患者中胃食管反流病与睡眠紊乱之间的关系
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内镜证实的胃食管反流病与阻塞性睡眠呼吸暂停的严重程度的相关性
