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Gut:反流性慢性咳嗽的影响因素有哪些?

2017-03-19 xing.T MedSci原创

由此可见,大量的反流物体积和较长时间的反流食管暴露似乎在诱导咳嗽中起着重要的作用,而与反流物的酸度似乎不相关。这有助于解释为什么大多数慢性咳嗽患者往往不受益于胃酸抑制治疗。

胃食管反流被认为是慢性不明原因咳嗽的重要原因。目前尚不清楚为什么在同一病人有些时候的反流发作会导致咳嗽,而有时有不会发生咳嗽。要了解更多的有关反流引起咳嗽的机制,近日,消化病领域权威杂志Gut上发表了一篇研究文章,研究人员旨在明确哪些重要的反流相关因素会触发咳嗽。

在这项多中心研究中,研究人员对49例伴有慢性咳嗽的胃食管反流患者进行24小时pH值压力监测并分析。研究人员分析了随后发生咳嗽的反流发作的特点,并与随之没有出现咳嗽的反流发作进行了比较。

大多数(72.4%)反流发作是酸性的(pH<4)。与反流发作之后没有发生咳嗽相比,反流发作之后发生咳嗽与更近的程度(P=0.0001),更高的容量清除时间(P=0.002),发生前15min更高的酸负荷(P=0.019)和发作前30min更高的反流负担(P=0.044)相关。当检查最低点的pH值、pH值下降、酸清除时间或酸性反流的百分比在两组之间无显著差异。

由此可见,大量的反流物体积和较长时间的反流食管暴露似乎在诱导咳嗽中起着重要的作用,而与反流物的酸度似乎不相关。这有助于解释为什么大多数慢性咳嗽患者往往不受益于胃酸抑制治疗。

原始出处:


Thomas V K Herregods, et al. Determinants of reflux-induced chronic cough. Gut. 2017. http://dx.doi.org/10.1136/gutjnl-2017-313721

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    2017-04-01 jyzxjiangqin

    胃食管反流是慢性咳嗽的重要原因。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=184198, encodeId=b44d1841985a, content=胃食管反流是慢性咳嗽的重要原因。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Apr 01 07:44:33 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181638, encodeId=49a0181638e3, content=胃食管反流被认为是慢性不明原因咳嗽的重要原因, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Tue Mar 21 09:48:03 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465531, encodeId=1c311465531b6, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571583, encodeId=c52015e15835a, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181498, encodeId=ee6c1814985b, content=很实用的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77711725691, createdName=doctor_hong, createdTime=Mon Mar 20 22:29:52 CST 2017, time=2017-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181157, encodeId=902b18115ec7, content=非常好的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Mar 19 15:37:25 CST 2017, time=2017-03-19, status=1, ipAttribution=)]
    2017-03-21 往日如昨

    胃食管反流被认为是慢性不明原因咳嗽的重要原因

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=184198, encodeId=b44d1841985a, content=胃食管反流是慢性咳嗽的重要原因。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Apr 01 07:44:33 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181638, encodeId=49a0181638e3, content=胃食管反流被认为是慢性不明原因咳嗽的重要原因, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Tue Mar 21 09:48:03 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465531, encodeId=1c311465531b6, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571583, encodeId=c52015e15835a, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181498, encodeId=ee6c1814985b, content=很实用的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77711725691, createdName=doctor_hong, createdTime=Mon Mar 20 22:29:52 CST 2017, time=2017-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181157, encodeId=902b18115ec7, content=非常好的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Mar 19 15:37:25 CST 2017, time=2017-03-19, status=1, ipAttribution=)]
    2017-03-21 feifers
  5. [GetPortalCommentsPageByObjectIdResponse(id=184198, encodeId=b44d1841985a, content=胃食管反流是慢性咳嗽的重要原因。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Apr 01 07:44:33 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181638, encodeId=49a0181638e3, content=胃食管反流被认为是慢性不明原因咳嗽的重要原因, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Tue Mar 21 09:48:03 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465531, encodeId=1c311465531b6, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571583, encodeId=c52015e15835a, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181498, encodeId=ee6c1814985b, content=很实用的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77711725691, createdName=doctor_hong, createdTime=Mon Mar 20 22:29:52 CST 2017, time=2017-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181157, encodeId=902b18115ec7, content=非常好的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Mar 19 15:37:25 CST 2017, time=2017-03-19, status=1, ipAttribution=)]
    2017-03-20 doctor_hong

    很实用的研究

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=184198, encodeId=b44d1841985a, content=胃食管反流是慢性咳嗽的重要原因。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Apr 01 07:44:33 CST 2017, time=2017-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181638, encodeId=49a0181638e3, content=胃食管反流被认为是慢性不明原因咳嗽的重要原因, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Tue Mar 21 09:48:03 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465531, encodeId=1c311465531b6, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571583, encodeId=c52015e15835a, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Tue Mar 21 04:51:00 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181498, encodeId=ee6c1814985b, content=很实用的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77711725691, createdName=doctor_hong, createdTime=Mon Mar 20 22:29:52 CST 2017, time=2017-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181157, encodeId=902b18115ec7, content=非常好的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Mar 19 15:37:25 CST 2017, time=2017-03-19, status=1, ipAttribution=)]
    2017-03-19 天涯183

    非常好的研究

    0

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