支气管哮喘患者24小时食管pH监测的分析

目的　许多研究发现支气管哮喘和胃食管酸反流有关 ,但是有关胃食管酸反流引起支气管哮喘的机制还并不是十分清楚 ,用 pH监测仪对支气管哮喘患者的胃食管酸反流进行监测 ,以进一步探讨哮喘病的发病机制。 方法　将 84例患者分为 3组 ,单纯反流组 (30例 ) ,哮喘组 (2 8例 ) ,哮喘伴反流组 (2 6例 )。应用敏感的 2 4小时食管 pH监测仪监测食管 pH的变化。 结果　伴有酸反流的哮喘患者的 2 4小时酸反流次数、超过 5分钟的反流次数和 pH <4的时间均明显高于无胃食管反流的支气管哮喘患者 ,但超过 5分钟的反流次数、最长反流时间和 pH <4的时间明显低于单纯有胃食管反流的患者。结论　伴有酸反流的支气管哮喘患者 ,其哮喘的发作与酸反流有密切的关系 ,但是其酸反流程度小于单纯有胃食管反流的患者。这说明此类患者的哮喘发作除与胃食管酸反流对食管下段的刺激有关外 ,对酸反应的高敏感性也是其发病的重要因素 ,因此与胃食管反流相关的支气管哮喘发作是这两方面作用的结果

Analysis of esophageal 24 h pH monitoring in asthmatic patients

Objective Many studies reported that asthma was related to the gastroesophageal reflux, but the mechanism was still unclear. Mechanism of asthma would be further explored in the patients with asthma by 24 h monitoring esophageal pH. Methods Total 84 patients were divided into three groups: gastroesophageal reflux disease(GERD)with no asthma (30);asthma(28);asthma with gastroesophageal reflux(26),all were monitored on their esophageal pH by 24 h pH monitor.Results Number of acid reflux episodes, number of episodes of greater than 5 minutes, and time of pH below 4 of asthmatic patients with reflux were significantly more than that of the patients with asthma,but number of episodes of greater than 5 minutes, time of pH below 4 and duration of longest episodes of asthmatic patients with reflux were significantly less than that of the patients with gastroesophageal reflux disease. Conclusion In asthmatic patients of gastroesophageal reflux, their occurrence of asthma is closely related to gastroesophageal acid reflux,but their degree of acid reflux is lower than that of patients with GERD.The stimulation of acid and more sensitivity of patients to stimulation of acid in lower esophagus were two important aspects that result in occurrence of asthma in the asthmatic patients with acid reflux.