老年性哮喘伴胃食管反流临床特点研究

目的　分析老年性哮喘合并胃食管反流 (GER)的临床特点 ,以提高确诊率和治愈率。方法　对经X线钡餐造影检查确诊的 6 0例老年性哮喘合并GER及 30例无合并GER的患者进行临床对比分析 ,并对老年性哮喘合并GER患者进行分组治疗 (A组给平喘药和抗GER药 ,B组单独给平喘药 )。结果　老年性哮喘合并GER患者哮喘典型症状出现率为 4 3%～6 2 % ,反流症状出现率为 92 % ;突发性喘息 10 0 %发生在夜间。哮喘症状的严重程度与X线检查的反流分级呈正相关。用平喘药加胃肠动力药和质子泵抑制剂治疗此型哮喘疗效极佳 ,而单纯用平喘药疗效不满意。结论　老年性哮喘合并GER是哮喘的一个特殊类型 ,其临床表现和治疗均有特点 ,X线钡餐造影检查和气道激发试验有助于确诊。此型哮喘须用平喘药和抗反流药联合治疗

Clinical character study of old-age asthma combined with gastroesophageal reflux

Objective It is to analyze the clinical character of old-age asthma combined with gastroesophageal reflux (GER) in order to increase the rates of diagnosis and cure.Methods 60 patients with old-age asthma combined with GER and 30 cases without combined with GER were both diagnosed with X-ray barium meal and were performed a clinical comparative analysis. The patients combined with GER were divided into two groups to perform the experiment treatment (group A was treated with antiasthmatic and anti-GER drugs, group B was treated with antiasthmatic drugs only).Results The typical symptom appearance rate of patients with old-age asthma combined with GER was 43% to 62% and the reflux symptom appearance rate was 92%. 100% of the paroxysmal pant occurred at night. The severity degree of asthma symptom was positive correlation with the reflux level diagnosed by X-ray. It was good to cure such asthma with antiasthmatic drugs, stomach-intestines motive drug and proton pump suppressive medicine. The effect of treatment only with antiasthmatic drug was not satisfied.Conclusion Old-age asthma combined with GER is a special type and is different with other type of asthma in clinical symptom and treatment. It is helpful to use X-ray barium meal examination and bronchial provocative test to receive accuracy diagnosis. It needs antiasthmatic drugs combined with anti-reflux drugs to treat this asthma.