【摘要】 目的研究胃食管反流病的综合致病因素及个体化差异。方法使用专用软件控制的高分辨多通道灌注测压系统（ＰＣｐｏｌｙｇｒａｆＨＲ瑞典产）测定了正常人１８例及胃食管反流病患者２２例的食管下括约肌压力、胃内压、食管体动力参数以及２４小时食管ｐＨ监测各项参数。结果患者组胃内压明显高于对照组（１６４±１．１９）ｋＰａ对（１．０３±１．０２）ｋＰａ，Ｐ＜００５；患者组屏障压明显低于对照组（－０．３６±１．５）ｋＰａ对（０７４±１１２）ｋＰａ，Ｐ＜００５；食管中、远段蠕动压力在湿咽时低于对照组（６１０±２．１１）ｋＰａ对（１０．３３±７．７２）ｋＰａ、（７．５３±３．６２）ｋＰａ对（１１．４１±４．３３）ｋＰａ，Ｐ＜００５；酸清除时间患者组较对照组明显延长（１．５１±１．４７）ｍｉｎ对（０．５９±０．７２）ｍｉｎ，Ｐ＜００５；ｐＨ＜４所占百分比患者组明显高于对照组（２１２７±１８３２）％对（１４３±１２５）％，Ｐ＜００５。结论胃食管反流病的发病机制为多因素综合作用，包括ＬＥＳ功能障碍，胃内压、屏障压异常，食管体蠕动异常及酸清除时间延长、酸反流持续时间延长，在综合致病因素中存在个体化差异，为临床制定治疗?更多还原

【Abstract】 Objective To study the comprehensive pathogenesis and individual difference of gastroesophageal reflux disease.Methods By using PC polygraf HR manometry testing system,esophageal manometry,incluing LESP、LESL、LESPP、GP,contraction pressure of the esophageal body and 24-hour pH of esophagus monitoring by digitrapper MKⅢ,we studied in 18 healthy persons and 22 patients with GERD.Results The pressure(kPa) of GP in the patients was significantly higher than that of the control group(1.64±1.19 to 1.03±1.02,P<0 05),the protective pressure in the patients was lower than that of the control group(-0.36±1.5 to 0.74±1.12,P<0 05),and the peristaltic amplitude(kPa) of mid-end of esophagus in the patients was also lower in wet(6.10±2.11 to 10.33±7.72;7.53±3.62 to 11.41±4.3,P<0 05;0.05 respectively),the time(min) of acid clearance in the patients was longer than that of the control group(1.51±1.47 to 0.59±0.72,P<0 05),the percentage(%) of pH<4 in the patients was significantly higher than that of the control group(21.27±18.32 to 1.43±1.25,P<0.05).Conclusion Many factors were involved in the pathogenesis of GERD,including LES dysfunction,the abnormal of GP、protective pressure、the peristaltic amplitude of esophageal body,the prologation of acid clearance and duration of acid reflux,which may act on a individual basis,providing a possible basis for the clinical treatment.更多还原