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气管支气管吸入胃液是促使哮喘发作的原因之一。食道下段括约肌无力,同时伴有或不伴有裂孔疝,常造成胃食道反流。手术修复食道下段括约肌功能,使呼吸道症状好转,可证明胃食道与呼吸道疾患之间的因果关系。28例成人严重哮喘,经详细检查确定为内源性哮喘,包括病史,特异过敏源,环境及家庭情况,用药史,体检,胸片,常规实验室检查,X线上消化道检查。部分病例还做了过敏源皮肤试验,免疫电泳,肺生理试验,心电图,X线副鼻窦摄片,肺动脉造影,支气管造影,食道胃内窥镜检。对照组468例都作了X线上消化道检查。结果是哮喘组28例中,裂孔疝18例,占64％,反流13例,占46％。对照组468例中,裂孔疝92例,占19％,反流23例,占5％。两组有显殊差别。(P<0.001)裂孔疝及反流在哮喘组中各年龄期出现,而对照组发病高峰在中年,哮喘组年龄小于30岁6例中仅2例裂孔疝,1例有反流,提示年龄大的哮喘患者易发生胃食道反流。
Tracheal bronchial inhalation of gastric juice is one of the causes of asthma attacks. Lower esophageal sphincter weakness, with or without hiatal hernia, often resulting in gastroesophageal reflux. Surgery to repair lower esophageal sphincter function, so that respiratory symptoms improved, can prove that the esophagus and respiratory disease causal relationship. 28 cases of severe asthma in adults, after detailed examination identified as endogenous asthma, including history, specific allergens, environmental and family conditions, medication history, physical examination, chest X-ray, routine laboratory tests, X-ray upper gastrointestinal tract examination. In some cases, allergen skin tests, immunoelectrophoresis, lung physiology tests, electrocardiograms, X-ray paranasal radiography, pulmonary angiography, bronchography, and esophagoscopy were performed. The control group of 468 patients were made on the X-ray on the digestive tract. The result is asthma group 28 cases, 18 cases of hiatal hernia, accounting for 64%, 13 cases of reflux, accounting for 46%. Control group 468 cases, hiatal hernia in 92 cases, 19%, 23 cases of reflux, accounting for 5%. There are significant differences between the two groups. (P <0.001). Hiatal hernia and reflux occurred in all age groups in the asthma group, while in the control group peaked at middle age. In the asthma group, there were only 2 cases of hiatal hernia in 6 cases younger than 30 years and 1 case had reflux, suggesting Gastroesophageal reflux is prone to occur in older asthmatics.