Clinical Study Of Bronchiectasis Combined With Gastroesophageal Reflux

Purpose:Bronchiectasis patients, the research by measuring the simplebronchiectasis complicated with gastroesophageal reflux(GastroesoPhageal reflux disease, GERD) in patients with resistance toinfections, oral esomeprazole magnesium (resistance) and clinicalsymptom score of symptomatic therapy, pulmonary function parametersand the level of nitric oxide in exhaled air (Fractional Concentration of,FENO) changes; Study on gastroesophageal reflux disease and treatmenteffect of bronchiectasis, and further validation of curative effect ongastroesophageal reflux disease-resistant, so as to provide more robusttheoretical basis for better diagnosis and treatment of diseases.Material and method:Select March2011to February2013Jilin University first hospitalbreathing internal medicine admitted of bronchial expansion patients350cases, are by lung CT check clear diagnosis, which merged GERDpatients39cases accounted for11.1%as support spread merged GERDgroup, from39cases merged GERD who in the random extraction20cases as a, group, remaining of19cases as b group, again from remainingof311cases simple bronchial expansion patients in the select with a,, andb group gender, and age, and bronchial expansion area, and The coursequite as simple in20patients with bronchiectasis group.59patients ages55～76sui, an average of65years old; the course of2～28, anaverage of16years.(Note:59cases of acute infection in patients with bronchiectasis).①diagnosis of bronchiectasis standard:350cases areexamined by high resolution CT of the Lung in patients with a cleardiagnosis;②standard diagnosis of gastroesophageal reflux disease: studyon gastroesophageal reflux disease in China produced by collaborativegroups of reflux disease questionnaire (GerdQ)[5], the symptoms are nottypical use of pH value of lower esophageal monitoring. Simpleexpansion group, and a group of patients receiving anti-inflammatory,doxofylline antiasthmatic, Bromo-new glucose injection and resolvingphlegm and other respiratory medicine General treatment for1week,group b patients accept the conventional treatment of respiratorymedicine and use of esomeprazole magnesium (letter), the course of1week. Measurement before and after treatment in patients withbronchiectasis Simplex groups, groups a, b, clinical symptom score, lungfunction and level of nitric oxide in exhaled gas, and compared threegroups of indicators before and after treatment in patients with nosignificant difference.Results:1, The institute selected three groups of patients before treatment,thebasic information, signs, symptoms score, no significant statisticaldifferences (p>0.05).2, Before treatment, simple group and the enlarged group comparedwith GERD bronchiectasis, symptoms, signs, score no significantstatistical differences (P>0.05), bronchiectasis with GERD groupindicators of lung function (FEV1, FVC, and FEV1/FVC) declined moresignificantly, FENO rise more visible, there was a statistically significantdifference (P<0.01). Simple anti-infection treatment of two groups ofsymptoms and signs of scoring after1week, pulmonary functional indexes and FENO than before the treatment significantly improved(P<0.01), and simple expansion group to improve more significantly(P<0.05).3，Treatment of bronchiectasis GERD before2, groups a, b, twosubgroups, points, lung function and symptoms, signs FENO nosignificant statistical differences (P>0.05). Group a simple antimicrobialtherapy, group b1week of resistance to infection and resistance in thetreatment showed combined with symptoms and signs of patients withtreatment-resistant Group b points, lung function and FENO a simpleantimicrobial therapy group a patients improved significantly (P<0.01),and very close to the simple spread results of Group1week ofantimicrobial therapy.Conclusion:1, Gastroesophageal reflux may add to the symptoms and signs ofpatients with bronchiectasis, lung function decline, FENO levels rise; andthe effectiveness of antimicrobial therapy.2, For patients with bronchiectasis and GERD, antimicrobial therapyalone is ineffective, resistance to infection and resistance in the treatmentcan significantly improve the symptoms and signs of patients withbronchiectasis and GERD, pulmonary function and FENO levels.3, FENO is a sensitive index to check the airway inflammation,FENO can objectively reflect changes in the airway inflammatoryresponses. In particular FENO is elevated in patients with chronicinflammation of respiratory tract and respiratory inflammatory responsewith FENO levels were positively correlated, as respiratory inflammatoryresponse to mitigate, FENO levels will decline[6].4, Letter (esomeprazole magnesium) is currently the best Proton pump inhibitors in the treatment of gastroesophageal reflux (Proton PumPinhibitor,PPI), it can be effective in reducing symptoms in patients withgastroesophageal reflux and merge there are symptoms and signs ofpatients with bronchiectasis, pulmonary function and a goodimprovement in FENO.5, General resistance to infection in patients with bronchiectasis,clean air, such as when a treatment is ineffective,considering theirincorporation of gastroesophageal reflux disease, acid reflux treatment, toimprove results.