在患有慢性限制性和阻塞性肺病的患者中,脊椎隔膜的选择性功能障碍
Jisha Joshua1, Chetna Pathak1, Ali Zifan2
1Division of Pulmonary Medicine, University of California San Diego, San Diego, California, USA.
患有慢性肺病的患者,特别是间歇性肺病 (ILD),表现出更高的跨隔膜压力 (Pdi) 和较低的食管胃结 (EGJ) 压力. 这表明,肌膜功能障碍有助于胃食道逆流性疾病 (GERD) 的流行.
科学领域:
- 肺部医学 肺部医学
- 胃肠病学 胃肠病学
- 隔膜生理学 隔膜生理学
背景情况:
- 胃食道逆流 (GER) 与慢性肺部疾病有关.
- 由隔膜收缩产生的跨隔膜压力 (Pdi),驱动GER.
- 肌膜收缩增加了食管胃结 (EGJ) 的压力,以防止GER.
研究的目的:
- 在患有间歇性肺病 (ILD) 和阻塞性肺病 (OLD) 的患者中研究Pdi和EGJ压力之间的关系.
- 探索膜膜功能在慢性肺病患者的GER和GERD中的作用.
主要方法:
- 使用高分辨率食道测量仪测量Pdi和EGJ压力.
- 该研究包括26名ILD患者,24名OLD患者和20名健康对照.
- 分析的重点是灵感时的压力差异和时间关系.
主要成果:
- 与对照组和OLD患者相比,ILD患者表现出明显更高的Pdi和较低的EGJ压力.
- 在ILD和一些OLD患者中,吸入时EGJ压力低于Pdi.
- 在ILD组中观察到更高的滑动间隙的患病率.
结论:
- 升高的Pdi和降低的EGJ压力,以及时解离,表明慢性肺部疾病中的选择性脊椎隔膜功能障碍.
- 这种功能障碍可能解释了在ILD患者中观察到的GERD患病率增加.
- 这些发现突出了隔膜在GER病理生理学和GERD发展中的作用.
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