【摘要】 目的　探讨胃内 pH值与胃食管反流的关系及胃 食管反流的病理生理机制。 方法　采用便携式 pH监测仪对 1 8例食管炎、1 2例食管溃疡、1 0例Barrett’s食管、1 5例健康人行 2 4h食管和胃 pH值同步监测 ,分别计算胃内各段 pH值、胃 食管酸反流次数、长反流次数、最长反流时间以及pH值 <4的时间占总时间的百分比。 结果　①食管炎组 :上述各项指标在胃内 pH值为 1～ 4时明显高于对照组 (P <0 .0 5 ) ;当胃内 pH值为 1～ 2时 ,酸反流次数明显高于其他pH值段 (P <0 .0 5 ) ;②食管溃疡组 :当胃内 pH值为 1～ 2时 ,酸反流次数、长反流时间明显高于其他 pH值段 (P <0 .0 5 ) ;胃内 pH值为 1～ 3时 ,酸反流次数、长反流时间明显高于对照组 (P <0 .0 5 ) ;③Barrett’s食管组 :胃内pH值为 2～ 3时的酸反流次数明显高于对照组 ;④当胃内 pH值为 1～ 2时 ,食管炎组、食管溃疡组酸反流次数明显高于Barrett’s食管组。结论　当胃内 pH值在 1～ 2之间时 ,食管炎、食管溃疡的胃食管酸反流最为明显 ,食管黏膜损伤的严重程度与食管接触酸的次数及接触酸的时间长短有关 ;Barrett’s食管的胃 食管酸反流与胃酸无明显关系更多还原

【Abstract】 Objective To study the relationship between the stomach pH and gastroesophageal reflux,and the gastroesophageal reflux pathology.Methods The 24 hour pH level in esophagus and stomach were monitored simultaneously in 18 esophagitis(esophagitis group),12 esophageal ulcer(esophageal ulcer group),10 Barrett’s esophagus(Barrett’s esophagus group) and 15 healthy subjects (control group).In addition,times of esophagus acid reflux and long reflux,the time of the longest reflux and the total fraction time of acid reflux when pH <4 (% pH<4)to acid reflux when stomatch pH was between 1 and 2,2 and 3,3 and 4,and pH>4 were calculated respectively.Results (1) Compared with the control group,the times of esophageal acid reflux, the times of long reflux,the time of the longest reflux,and %pH<4 were significantly higher in esophagitis group when stomach pH was between 1 and 4.When stomach pH was between 1 and 2,the times of esophagus acid reflux were significantly higher than those when the pH was >2.(2)When stomatch pH was between 1 and 2,the times of esophagus acid reflux and long reflux were significantly higher than that when pH>2.When stomatch pH was between 1 and 3,the times of esophagus acid reflux and long reflux in esophageal ulcer group were significantly higher than those in the control group.(3) When stomach pH was between 2 and 3,the times of esophagus acid reflux were significantly higher in the Barrett’s esophagus group than those in the control group.(4) When stomatch pH was between 1 and 2,the times of esophagus acid in reflux were significantly higher in esophagitis group and esophageal ulcer group than in Barrett’s esophagus group.Conclusions When stomach pH is between 1 and 2,the esophagus acid in reflux in esophagitis and esophagitis ulcer is most prominent,but the Barrett’s esophagus has no relation with the gastric acid,and the bowl stomach reflux is not related to esophagus acid reflux.更多还原