CAJ | 학술논문

目的明确特发性肺间质纤维化(IPIF)患者胃食管反流病(GERD)的患病率,探讨GERD与IPIF的关系.方法对2006年12月至2008年1月在首都医科大学附属北京朝阳医院呼吸科住院确诊的24例IPIF患者进行24 h食管pH监测和食管测压,同期住院的23例非IPIF的弥漫性实质性肺疾病患者作为对照.比较两组患者GERD症状、病理性食管酸暴露及无效食管动力(IEM)的发生率.结果 (1)66.7%(16/24)的IPIF患者存在病理性食管酸暴露,明显高于对照组的26.10k(6/23),P<0.05;(2)在具有病理性酸暴露的IPIF(GERD-IPIF)患者中,87.5%(14/16)存在夜间酸暴露事件;(3)典型GERD症状在GERD-IPIF患者中的发生率只有37.5%(6/16);(4)IPIF组和非IPIF组患者IEM发生率相似,分别为42.9%(9/21)和39.1%(9/23),P>0.05.结论在IPIF患者中GERD患病率较高,但多数患者没有典型GERD症状,IPIF患者应该进行24 h食管pH监测筛查GERD.
목적 명학특발성폐간질섬유화(IPIF)환자위식관반류병(GERD)적환병솔,탐토GERD여IPIF적관계.방법 대2006년12월지2008년1월재수도의과대학부속북경조양의원호흡과주원학진적24례IPIF환자진행24 h식관pH감측화식관측압,동기주원적23례비IPIF적미만성실질성폐질병환자작위대조.비교량조환자GERD증상、병이성식관산폭로급무효식관동력(IEM)적발생솔.결과 (1)66.7%(16/24)적IPIF환자존재병이성식관산폭로,명현고우대조조적26.10k(6/23),P<0.05;(2)재구유병이성산폭로적IPIF(GERD-IPIF)환자중,87.5%(14/16)존재야간산폭로사건;(3)전형GERD증상재GERD-IPIF환자중적발생솔지유37.5%(6/16);(4)IPIF조화비IPIF조환자IEM발생솔상사,분별위42.9%(9/21)화39.1%(9/23),P>0.05.결론 재IPIF환자중GERD환병솔교고,단다수환자몰유전형GERD증상,IPIF환자응해진행24 h식관pH감측사사GERD.
Objective To determine the prevalence of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary interstitial fibrosis (IPIF). Methods From December 2006 to January 2008, 24 consecutive patients with IPIF admitted to Beijing Chaoyang Hospital underwent 24-hour esophageal pH monitoring and esophageal manometry. Meanwhile, 23 patients with diffuse parenchymal lung disease (DPLD) (excluding IPIF) admired to the hospital in the same period served as a control group. Comparison of the prevalence of pathologic esophageal acid exposure GERD symptoms, and ineffective esophageal motility (IEM) between the two groups was made. In this study, nocturnal acid exposure is defined as acid reflux episodes occurring from 10pro to 6am. Results (1) 16 out of the 24 (66. 7%) patients with IPIF were demonstrated to have pathologic esophageal acid exposure; the prevalence of GERD in IPIF patients was significantly higher than that in other DPLD patients, whose prevalence was 26. 1% (P<0.05); (2) 87.5% patients with IPIF and GERD (GERD-IPIF) had nocturnal acid exposure episodes; (3) only 37.5% of the GERD-IPIF patients was found to have typical GERD symptoms such as heartburn and regurgitation; (4) The prevalence of IEM was similar in IPIF and other DPLD patients, being 42.9% and 39. 1% respectively (P >0. 05). Conclusions IPIF patients have higher prevalence of GERD and most of them usually do not show typical reflux symptoms. It is hereby suggested that IPIF patients should be screened with pH monitoring for GERD.