胃食管反流病与肺功能的相关性研究

发布时间：2018-07-01 18:01

  本文选题：胃食管反流病 + 肺功能　； 参考：《扬州大学》2017年硕士论文

【摘要】：第一部分胃食管反流病与肺功能的相关性目的:探讨胃食管反流病(GERD)与肺功能之间的相关性,进一步分析其与肺通气功能障碍程度以及不同类型肺通气功能损害之间的关系。方法:选取2015年3月至2015年6月在江苏省苏北人民医院肺功能室完成肺功能检查的人,共纳入540例研究对象,其中319例经肺功能检查诊断为肺通气功能障碍组,221例健康体检者为对照组,分别进行RDQ评分问卷调查。比较肺通气功能障碍组与对照组的GERD发生率是否具有统计学差异,不同肺通气功能障碍程度之间GERD发生率、RDQ评分是否具有统计学差异,以及不同类型的肺通气功能障碍患者GERD的发生率、RDQ评分有无显著性差异。结果:肺通气功能障碍组GERD59例(18.50%),对照组GERD20例(9.05%),肺通气功能障碍组GERD的发生率明显高于对照组(χ2=9.326,P0.05),且肺通气功能障碍组患者RDQ评分明显高于对照组(P0.05)。随着肺通气功能障碍程度的加重,GERD的发生率逐渐升高,组间差异具有统计学意义(χ2=14.087,P0.05),且不同障碍程度组间RDQ评分具有统计学意义(P0.05);在阻塞性肺通气功能障碍与混合性通气功能障碍两种不同类型的肺通气功能损害性质之间,GERD的发生率及RDQ评分均无明显统计学意义 CP0.05)。结论:肺通气功能障碍的患者发生GERD的风险较高,且GERD的发生与肺通气功能障碍的程度密切相关。低氧血症可能参与了 GERD的发病机制。第二部分肺功能障碍合并GERD的危险因素目的:近年来GERD发病率呈逐渐升高的趋势,与多种因素影响有关。本部分主要探讨合并有肺通气功能障碍的GERD患者的危险因素,以便进一步指导临床工作。方法:纳入肺通气功能障碍的患者共319例,依据RDQ评分≥12分作为GERD的临床评判标准,将其分为GERD阳性组和GERD阴性组。通过问卷调查的形式,对以上两组患者的性别、年龄、BMI、吸烟、饮酒、肺功能等因素进行数据分析,研究肺功能障碍合并GERD的危险因素。结果:GERD 阳性组患者 FEV1%pr.、FEV1/FVC%pr.、DLCO%pr.较 GERD 阴性组低,且差异具有统计学意义(P0.05)。吸烟也是GERD发生的危险因素,而性别、年龄和饮酒在GERD阳性组与阴性组之间无明显统计学差异(P0.05)。进一步通过多因素非条件Logistic回归分析,发现BMI(OR 1.176,95%CI1.077～1.285)是肺通气功能障碍合并GERD的独立危险因素,肺弥散功能(OR 0.981,95%CI0.963～0.998)是其保护性因素。结论:在肺通气功能障碍的患者中,BMI、吸烟和肺弥散功能差的患者发生胃食管反流症状的风险更高。
[Abstract]:Part I the correlation between gastroesophageal reflux disease and lung function objective: to investigate the relationship between gastroesophageal reflux disease (GERD) and pulmonary function, and to analyze the relationship between GERD and pulmonary ventilation dysfunction and different types of pulmonary ventilation dysfunction. Methods: 540 subjects were selected from March 2015 to June 2015, who completed the pulmonary function examination in the lung function room of Subei people's Hospital of Jiangsu Province. Among them 319 cases were diagnosed by pulmonary function examination as pulmonary ventilation dysfunction group 221 healthy persons as control group RDQ scores were investigated respectively. To compare the incidence of GERD in pulmonary ventilation dysfunction group and control group, and whether there was statistical difference in GERD incidence rate and RDQ score between different degree of pulmonary ventilation dysfunction. The incidence of GERD and RDQ scores in patients with different types of pulmonary ventilation dysfunction were significantly different. Results: GERD was found in 59 patients (18.50%) in the pulmonary ventilation dysfunction group and in 20 (9.05%) in the control group. The incidence of GERD in the pulmonary ventilation dysfunction group was significantly higher than that in the control group (蠂 2 9.326 P 0.05), and the RDQ score in the pulmonary ventilation dysfunction group was significantly higher than that in the control group (P0.05). With the exacerbation of pulmonary ventilation dysfunction, the incidence of GERD increased gradually. The difference between the two groups was statistically significant (蠂 2 + 14.087% P0.05), and the RDQ score of different degree of disturbance was statistically significant (P0.05), and the two types of pulmonary ventilation dysfunction in obstructive pulmonary ventilation dysfunction and mixed ventilation dysfunction were different in nature of pulmonary ventilation dysfunction. There was no significant difference in the incidence of GERD and RDQ score (CP0.05). Conclusion: the risk of GERD in patients with pulmonary ventilation dysfunction is higher, and the occurrence of GERD is closely related to the degree of pulmonary ventilation dysfunction. Hypoxia may be involved in the pathogenesis of GERD. The second part: the risk factors of pulmonary dysfunction complicated with GERD: in recent years, the incidence of GERD is increasing gradually, which is related to many factors. This part mainly discusses the risk factors of GERD patients with pulmonary ventilation dysfunction. Methods: 319 patients with pulmonary ventilation dysfunction were divided into GERD positive group and GERD negative group according to RDQ score 鈮，

本文编号：2088609