Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis
Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis
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DOI：
10.1164/ajrccm.158.6.9804105
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发表时间：
1998-12-01
影响因子：
24.7
通讯作者：
Raghu, G
中科院分区：
文献类型：
--
作者：
Tobin, RW;Pope, CE;Raghu, G
特发性肺纤维化（IPF）是一种病因不明的进行性、致命性间质性肺疾病（ILD）。将酸引入呼吸树会导致肺纤维化。胃食管反流 (GER) 此前曾被认为与其他几种呼吸系统疾病有关，包括肺炎、支气管炎和哮喘。为了前瞻性地研究 CER 和 IPF 之间可能的关联，对 17 名经活检证实的连续 IPF 患者和 8 名除 IPF 之外的 ILD 对照患者进行了双通道动态食管 pH 监测。 17 名 IPF 患者中，有 16 名远端和/或近端食管酸暴露异常，而 8 名对照患者中有 4 名出现异常 (p = 0.02)。在 IPF 患者中，远端总（13.6 对比 3.34，p = 0.006）、远端直立（12.4 对比 5.1，p = 0.04）、远端仰卧（14.7 对比 0.88，p = 0.02）和近端仰卧（7.48 对比 0.24，p = 0.04）食管酸暴露时间的平均百分比显着高于对照组患者。控制患者。只有 4 名酸暴露增加的 IPF 患者 (25%) 出现典型的反流症状，如胃灼热或反流。 IPF 患者食管酸暴露增加的患病率很高，通常没有典型的 GER 症状，这些患者的 GER 往往发生在：夜间，并延伸到近端食管。胃酸反流可能是 IPF 发病机制的一个促成因素。
Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal interstitial lung disease (ILD) of unknown etiology. introduction of acid into the respiratory tree can produce pulmonary fibrosis. Gastroesophageal reflux (GER) has previously been associated with several other respiratory conditions, including pneumonia, bronchitis, and asthma. To investigate prospectively the possible association of CER and IPF, 17 consecutive patients with biopsy-proven IPF and eight control patients with ILD other than IPF underwent dual-channel, ambulatory esophageal pH monitoring. Sixteen of 17 patients with IPF had abnormal distal and/or proximal esophageal acid exposure compared with four of eight control patients (p = 0.02). In the patients with IPF, mean percent distal total (13.6 versus 3.34, p = 0.006), distal upright (12.4 versus 5.1, p = 0.04), distal supine (14.7 versus 0.88, p = 0.02), and proximal supine (7.48 versus 0.24, p = 0.04) esophageal acid exposure times were significantly greater than those in control patients. Only four patients with IPF (25%) with increased acid exposure had typical reflux symptoms such as heartburn or regurgitation. Patients with IPF have a high prevalence of increased esophageal acid exposure, usually without typical GER symptoms, GER in these patients fends to occur at: night and extend into the proximal esophagus. Acid reflux may be a contributing factor in the pathogenesis of IPF.