Multiple Factors Analysis Of Gastroesophageal Reflux Disease Patients With Chronic Cough Symptoms

Gastroesophageal reflux disease(GERD) is a common digestive tract disease, with the development of society, the incidence of this disease is increasing. The clinical manifestations of the disease can be divided into typical symptoms, atypical symptoms; typical symptoms include heartburn, reflux; atypical symptoms include cough, pharynx difficulty, globus hystericus etc; cough is a common atypical symptoms clinical manifestations of GERD patients, but it affect the quality of life in patients with atypical clinical symptoms. This study explores esophageal high resolusion manometry(HRi M) and dynamic 24h-p H monitoring for gastroesophageal reflux disease(GERD) in patients with cough, and aims to explores the risk factors of the GERD patients with cough symptoms.Methods:(1) we select 254 GERD patients and healthy control group(62 cases) who did esophageal esophageal high resolution manometry(HRi M) and dynamic 24h-p H monitoring of reflux disease(GERD) in our Outpatient Department from2010.5 to 2015.4; According to the clinical symptoms of GERD patients,we divided all people into two groups: chronic cough as the main symptoms of GERD group(referred to as: cough GERD group)and non-cough GERD group(2) we retrospectively analyze gender, age, comorbidities, clinical symptoms, the data of HRi M and dynamic 24h-PH monitoring;(3) statistical analysis: using spss20.0 statistical software to analyze the data, P < 0.05 considered significant.Results: The age of GERD with cough patients ranges from 24 to 84 year(53.15±14.91),and displays two peaks, both 30-34 and 55-64.IRP(5.94 ±570mm Hg) of cough GERD group is significantly lower than IRP(7.22 + 684 mm Hg) of non-cough GERD, P < 0.05; Viscous clearance rate 29.92%(20.0%, 50.0%) of cough GERD group is significantly lower than 39.05%(10.0%, 70.0%) of non-cough GERD group, P < 0.05; Supine non-acid reflux times 2.14(0,3.0) of cough GERD group than of 1.16) is significantly less than 1.16(0,2.0) of non-cough GERD group, P < 0.05; Non-acid bolus exposure time 1.59(0.5,2)of cough GERD group and supine non-acid food bolus exposure time 0.41(0,0.5) are significantly longer than 1.22(0,2.0)、0.18(0,0)of non-cough GERD group, P < 0.05;Vertical proximal acid reflux episodes is 9.02(3.0,15.0), 11.67(4.0,16.0), 5.74(2.0,9.0) in cough GERD group, non-cough GERD and the control group, vertical proximal acid reflux episodes of cough GERD group is less than non-cough GERD group’s, and more than the control group’s(p<0.05).There are 45 differences between GERD with cough and normal control group in all indexes, such as liquid viscous clearance, clearance rate, distal esophageal peristalsis amplitude, IRP, UESP,P < 0.05.There are significant differences in IRP, viscous clearance rate, distal supine non-acid reflux episodes, vertical proximal acid reflux episodes, supine proximal non-acid reflux episodes, vertical non-acid bolus exposure time, supine non-acid bolus exposure time for cough and non-cough group, P < 0.05. Logistic regression analysis shows that With typical symptoms of gastroesophageal reflux disease patients compared, lower esophageal sphincter pressure, viscous bolus clearance of the disorder, longer supine non-acid bolus exposure time, more supine proximal non-acid reflux episodes are primary esophageal dynamic mechanical abnormalities and anti-flow characteristics for chronic cough as main symptoms of gastroesophageal reflux disease patients.Conclusion: With typical symptoms of gastroesophageal reflux disease patients compared, lower esophageal sphincter pressure, viscous bolus clearance of the disorder, longer supine non-acid bolus exposure time, more supine proximal non-acid reflux episodes are primary esophageal dynamic mechanical abnormalities and anti-flow characteristics for chronic cough as main symptoms of gastroesophageal reflux disease patients.