重度反流性食管炎的食管酸反流特点与胃酸分泌相关性研究

Pattern of esophageal acid exposure and gastric acid secretion in patients with serious reflux esophagitis

关键词:  反流性食管炎  24 h动态食管pH 监测  胃液分析

Key words:  reflux esophagitis  24 hours continuous esophageal pH monitoring  gastric acid secretion

摘要:

［目的］探讨食管酸反流特殊方式与反流性食管炎（reflux esophagitis, RE）的严重程度是否关联，以及胃酸度与RE严重程度的相关性。［方法］35例不同程度的RE患者和10名健康正常人均接受24 h动态食管pH 监测和胃液分析检查。［结果］ ①反流持续超过5 min的次数（number of reflux lasting more than five minutes，NR₅）与反流性食管炎的相关系数最大（P＜0.05），随着RE严重程度从Ⅰ级递增至Ⅳ级， NR₅数值同步提高（P＜0.05）。② 重度RE组100%有（或伴有）高酸型NR₅（pH≤2，且持续时间＞5 min）食管酸反流；轻中度RE组 35%有（或伴有）高酸型NR₅食管酸反流，而健康正常组无1例有（或伴有）高酸型NR₅食管酸反流。③ 重度RE组的最大酸排量及高峰酸排量明显高于轻中度RE组和健康正常组。［结论］食管高酸度NR₅反流模式是导致重度RE的因素之一。

Abstract:

［Objective］To explore the relationship between the pattern of esophageal acid exposure and the severity of reflux esophagitis(RE). ［Methods］All subjects received 24 hours continuous introesophageal pH monitoring. Parameters included NR₅, number of reflux and the longest time of reflux. At the same time, acidsecretion levels were studied which were basic acidoutput(BAO), most acid output(MAO), and peak acid output(PAO). ［Results］ ① Three parameters, i.e, NR₅, number of reflux and the longest time of reflux are related to RE , but NR₅ is of the most value among three parameters on diagnosis of RE(illus at table 1). The more serious of RE gets, the greater number of NR₅ is(illus at table 2). ② a hundred percent of patients with serious RE (Ⅳdegree RE) partly or entirely showed higher acid NR₅ pattern (pH≤2 and over 5 minutes). Thirty five percent of patients with Ⅰdegree- Ⅲdegree RE partly or entirely showed that special NR₅ pattern( pH≤2 and over 5 minutes). No higher acid NR₅ pattern was partly or entirely showed in health subjects.③ The amounts of MAO and PAO for patients of serious RE are larger than those for patients of Ⅰ degree- Ⅲdegree RE or for health subjects. ［Conclusion］higher acid mode of NR₅ plays an important role in the pathogenesis of serious RE.