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논문 기본 정보

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학술저널
저자정보
Lawrence F Borges (Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Boston MA US) Vikrant Jagadeesan (Harvard Medical School Boston MA USA) Hilary Goldberg (Harvard Medical School Boston MA USA) Sravanya Gavini (Division of Gastroenterology University of Texas Southwestern Medical Center Dallas TX USA) Wai-Kit Lo (Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Boston MA US) Robert Burakoff (Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Boston MA US) Natan Feldman (Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Boston MA US) Walter W Chan (Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Boston MA US)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.24 No.3
발행연도
2018.1
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395 - 402 (8page)

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Background/Aims Gastroesophageal reflux (GER) is postulated to play a role in idiopathic pulmonary fibrosis (IPF). However, the value of objective GER measures in predicting IPF disease progression is unclear. We aim to evaluate the association between objective GER measures on multichannel intraluminal impedance and pH (MII-pH) testing and development of poor pulmonary outcomes within 1 year in pre-lung transplant IPF patients. Methods This was a retrospective cohort study of adults with IPF who underwent pre-lung transplant evaluation with MII-pH off proton pump inhibitors (PPI) at a tertiary care center from June 2008 to November 2015. Patients were followed for 1 year from time of MII-pH for poor pulmonary outcomes, defined by hospitalization for respiratory exacerbation or death. Univariate, multivariate and time-to-event analyses were performed to assess associations between baseline GER parameters on MII-pH and poor outcomes. Results Eighty-four subjects (mean age 61.1 years, 64.3% male) were included. Subjects with increased bolus exposure time (BET) had a higher incidence of 1-year poor pulmonary outcome vs normal BET (45.7% vs 15.2%, P = 0.006). Increased BET remained an independent predictor of poor outcome after controlling for age, gender, body mass index, smoking, lung disease severity, and PPI use (OR, 4.18; P = 0.030). Increased BET was also predictive of decreased time to poor pulmonary outcome (hazard ratio [HR], 4.88; P = 0.007). Subgroup analyses showed that increased BET remained independently associated with time to pulmonary hospitalization (HR, 4.00; P = 0.020), with a trend for 1-year mortality (HR, 2.19; P = 0.380). Conclusion Increased BET on MII-pH is an independent predictor of poor pulmonary outcome over 1 year in IPF patients.

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참고문헌 (21)

참고문헌 신청
Savarino E / 2013 / Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients / Eur Respir J 42:1322~1331 Crossref Tobin RW / 1998 / Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis / Am J Respir Crit Care Med 158:1804~1808 Crossref Gavini S / 2015 / Idiopathic pulmonary fibrosis is associated with increased impedance measures of reflux compared to nonfibrotic disease among pre-lung transplant patients / Neurogastroenterol Motil 27:1326~1332 Crossref Raghu G / 2011 / An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management / Am J Respir Crit Care Med 183:788~824 Crossref Hirano I / 2007 / ACG practice guidelines: esophageal reflux testing / Am J Gastroenterol 102:668~685 Crossref

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