Clinical Relevance Of Interstitial Pulmonary Disease And Gastroesophageal Reflux Disease

Objective:Interstitial lung disease is a disease group of alveolar wall and its adjacent tissue lesion,and the parenchyma and alveolar parenchyma can also be damaged on this basis.It has become a common clinical disease.Due to its complex etiology and large difference in survival,it is a difficult problem for clinical diagnosis and treatment,and it is necessary to study its correlation and related diseases.Gastroesophageal reflux disease(GERD)is a common disease in the digestive system.The symptoms are two types of esophagus and esophagus.In recent years,GERD has been increasing year by year with the expression of esophageal syndrome,among which cough,asthma and other patients are not rare.And Idiopathic pulmonary fibrosis(Idiopathic pulmonary fibrosis.)as a group of ILD disease in clinical,fatality rate is highest,the most common research has become the most comprehensive disease of GERD suspicious performance,for the research of the relationship between ILD and GERD.This study is to investigate the clinical relevance of interstitial lung disease(ILD)and gastroesophageal reflux disease(GERD).To study the characteristics of gastroesophageal reflux in the patients with ILD;To study the correlation between lung function and imaging performance and other indicators of gastric esophageal reflux.Materials and methods:90 patients with interstitial lung disease(31 IPF,59 non-IPF)were entrolled from Department of Respiratory Disease in the First Affiliated Hospital of China Medical University during the past six years.All the patients were subjected 24-hour esophageal pH monitoring and Gastroesophageal reflux questionnaire,esophageal pH monitoring results in GERD positive with GERD negative group,all of the patients in esophageal pH monitoring before did not use hormone therapy.The degree of pulmonary fibrosis was expressed in a clear lung HRCT score,and three images were recorded(ground glass,grid shadow,and honeycomb).The lung function of patients(TLC,FVC,DLCO)was collected.Reflux indexes include:DeMeester score,reflux cycle number,total acid reflux time acid reflux%,the upright position,supine acid reflux,reflux cycle number>5 min,reflux index,total alkaline reflux time alkaline reflux,the upright position,supine alkaline reflux.Results:1.The number of GERD positive groups was 51,which was significantly higher than that in the GERD negative group.In 87 patients,GERD-Q score was correlated with DeMeester score,and Pearson correlation coefficient r=0.835(P<0.001).2.In the two groups,72 patients completed HRCT score,and the correlation coefficient r=-0.010 and P>0.05 was performed on the correlation coefficient between the score and the patient DeMeester score.This part of the patients with lung function DeMeester score on correlation analysis of FVC%(79 cases)and TLC(50 cases),DLCO(69 cases),FEV1/FVC(78cases)and DeMeester score were 0.100,0.052,0.106,0.130,P>0.05.The correlation analysis between image change(ground glass,grid shadow and honeycomb shadow)and lung field distribution in patients(arcus aortae,tracheal bifurcation,1cm on the diaphragm)was analyzed with the DeMeester score,the result is-0.109.0.015.-0.049.-0.055.-0.049.0.018,P>0.05.In terms of HRCT score and lung function(TLC,FEVi/FVC,FVC,DLCO),the GERD positive group was compared with the negative group,and the difference between the two groups was not statistically significant,as shown in table 1.After the comparison and analysis of three images(ground glass,grid shadow and honeycomb shadow)on HRCT of the patients(48 patients)from 2014 to 2017,the data of the two groups were not statistically significant,as shown in table 2.3.A total of 31 IPF patients in the GERD+-two groups,30 of them completed HRCT score,and the correlation analysis between DeMeester and the score was 0.129,and P>0.05.The number of cases of lung function in patients with complete different measurement of TLC respectively(24 cases),DLCO(28 cases)FEVi/FVC(31 cases),FVC(31 cases),correlation coefficient were 0.013,-0.305,0.185,0.184,P values were greater than 0.05.The lung volume index and HRCT score of IPF patients in the group were compared,and the results were shown in table 3.Conclusion:ILD patients should have 24-hour esophageal pH monitoring when necessary.GERD-Q questionnaire can be used to diagnose GERD in primary hospitals without 24-hour esophageal pH monitoring.There may be no specific changes in the imaging manifestations and the distribution of lung field of ILD patients who have been combined with GERD,and GERD may have no significant influence on the degree of pulmonary fibrosis change in the ILD and IPF in imaging.Lung function indicators such as TLC and FVC may not reflect changes in lung volume in GERD and esophageal sphincter pressure.