本文選題：胃食管反流病 + 肺功能�。� 參考：《揚州大學》2017年碩士論文

【摘要】：第一部分胃食管反流病與肺功能的相關(guān)性目的:探討胃食管反流病(GERD)與肺功能之間的相關(guān)性,進一步分析其與肺通氣功能障礙程度以及不同類型肺通氣功能損害之間的關(guān)系。方法:選取2015年3月至2015年6月在江蘇省蘇北人民醫(yī)院肺功能室完成肺功能檢查的人,共納入540例研究對象,其中319例經(jīng)肺功能檢查診斷為肺通氣功能障礙組,221例健康體檢者為對照組,分別進行RDQ評分問卷調(diào)查。比較肺通氣功能障礙組與對照組的GERD發(fā)生率是否具有統(tǒng)計學差異,不同肺通氣功能障礙程度之間GERD發(fā)生率、RDQ評分是否具有統(tǒng)計學差異,以及不同類型的肺通氣功能障礙患者GERD的發(fā)生率、RDQ評分有無顯著性差異。結(jié)果:肺通氣功能障礙組GERD59例(18.50%),對照組GERD20例(9.05%),肺通氣功能障礙組GERD的發(fā)生率明顯高于對照組(χ2=9.326,P0.05),且肺通氣功能障礙組患者RDQ評分明顯高于對照組(P0.05)。隨著肺通氣功能障礙程度的加重,GERD的發(fā)生率逐漸升高,組間差異具有統(tǒng)計學意義(χ2=14.087,P0.05),且不同障礙程度組間RDQ評分具有統(tǒng)計學意義(P0.05);在阻塞性肺通氣功能障礙與混合性通氣功能障礙兩種不同類型的肺通氣功能損害性質(zhì)之間,GERD的發(fā)生率及RDQ評分均無明顯統(tǒng)計學意義 CP0.05)。結(jié)論:肺通氣功能障礙的患者發(fā)生GERD的風險較高,且GERD的發(fā)生與肺通氣功能障礙的程度密切相關(guān)。低氧血癥可能參與了 GERD的發(fā)病機制。第二部分肺功能障礙合并GERD的危險因素目的:近年來GERD發(fā)病率呈逐漸升高的趨勢,與多種因素影響有關(guān)。本部分主要探討合并有肺通氣功能障礙的GERD患者的危險因素,以便進一步指導臨床工作。方法:納入肺通氣功能障礙的患者共319例,依據(jù)RDQ評分≥12分作為GERD的臨床評判標準,將其分為GERD陽性組和GERD陰性組。通過問卷調(diào)查的形式,對以上兩組患者的性別、年齡、BMI、吸煙、飲酒、肺功能等因素進行數(shù)據(jù)分析,研究肺功能障礙合并GERD的危險因素。結(jié)果:GERD 陽性組患者 FEV1%pr.、FEV1/FVC%pr.、DLCO%pr.較 GERD 陰性組低,且差異具有統(tǒng)計學意義(P0.05)。吸煙也是GERD發(fā)生的危險因素,而性別、年齡和飲酒在GERD陽性組與陰性組之間無明顯統(tǒng)計學差異(P0.05)。進一步通過多因素非條件Logistic回歸分析,發(fā)現(xiàn)BMI(OR 1.176,95%CI1.077～1.285)是肺通氣功能障礙合并GERD的獨立危險因素,肺彌散功能(OR 0.981,95%CI0.963～0.998)是其保護性因素。結(jié)論:在肺通氣功能障礙的患者中,BMI、吸煙和肺彌散功能差的患者發(fā)生胃食管反流癥狀的風險更高。
[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，

本文編號：2088609