被误诊为“胃食管反流病诱发的哮喘”过度换气综合征1例  

A case of hyperventilation syndrome misdiagnosed as"asthma induced by gastroesophageal reflux disease"

作　　者：李亚倩 张洁[1] 王邦茂[1] LI Yaqian;ZHANG Jie;WANG Bangmao(Department of Gastroenterology,Tianjin Medical University General Hospital,Tianjin,300052,China)

机构地区：[1]天津医科大学总医院消化内科,天津300052

出　　处：《中国中西医结合消化杂志》2025年第3期300-302,309,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：胃食管反流病是一种常见的消化系统疾病,以烧心和反酸为主要临床表现。临床上焦虑躯体化的患者也常自述为上腹部烧灼感或口腔“发酸”而被误诊为胃食管反流病的表现。过度换气综合征是一种焦虑躯体化的身心疾病,常因气急、胸闷、憋喘等症状而被误诊为哮喘。本文报道1例上腹部烧灼感合并过度换气综合征的焦虑患者被误诊为“胃食管反流病诱发的哮喘”,而长期误用质子泵抑制剂和糖皮质激素气雾剂导致患者因低钾血症多次住院治疗。经多学科专家会诊,停用质子泵抑制剂和糖皮质激素气雾剂,应用抗焦虑抑郁等药物治疗后患者症状完全缓解,长期随访无复发。特此报道,以期提高对GERD鉴别诊断的重视。Gastroesophageal reflux disease is a common digestive system disorder,characterized primarily by heartburn and sour regurgitation.Patients with anxiety-related somatization often report symptoms such as a burning sensation in the upper abdomen or a"sour"feeling in the mouth,which are misdiagnosisd as gastroesophageal reflux disease.Hyperventilation syndrome is a kind of psychosomatic disorder characterized by anxiety-related somatization,which often misdiagnosed as asthma due to symptoms such as shortness of breath,chest tightness,and dyspnea.This article reports a case of an anxiety patient with upper abdominal burning sensation combined with hyperventilation syndrome,who was misdiagnosed as having"asthma induced by gastroesophageal reflux disease".Long-term misuse of proton pump inhibitors and corticosteroid inhalers due to misdiagnosis has led to recurrent hospitalizations for prolonged hypokalemia.After consultation with multiple disciplinary team,proton pump inhibitors and corticosteroid aerosols were discontinued,and medications for anxiety and depression were administered,resulting in complete remission of the patient's symptoms.There was no recurrence during long-term follow-up.This report aims to raise awareness of the importance of differential diagnosis for gastroesophageal reflux disease.

关 键 词：胃食管反流病 哮喘 过度换气综合征 低钾血症 焦虑 

分 类 号：R256.3[医药卫生—中医内科学]