【摘要】 【目的】探讨胃食管反流病(GERD)患者中卧、立位的酸反流模式与食管黏膜损伤严重度的关系。【方法】91例以烧心和/或反酸为主诉,病史超过3个月的患者,根据内镜检查和24 h食管pH监测结果,分为非糜烂性反流病(NERD)组(50例)和糜烂性食管炎(EE)组(41例)。对两组患者卧、立位食管pH监测的指标进行对比分析。同时比较EE组中A,B级食管炎(32例)和C级食管炎(9例)之间卧、立位食管pH监测指标的异同。【结果】EE组患者卧位食管酸反流次数,长时间反流次数,最长反流持续时间,pH<4.0的时间百分比中位数分别为27(0~246),1(0~11),10(0~102),5.4(0~72);明显高于NERD组的12.5(0~68),0(0~8),5(0~53),2(0~24.7),而立位食管测酸各指标都与NERD组差异无显著性。C级食管炎患者卧位长时间反流次数和卧位最长反流持续时间显著高于A、B级食管炎组。【结论】卧位酸反流与食管黏膜损伤的发生及其严重程度有关。更多还原

【Abstract】 【Objective】To investigate the correlation of esophageal acid reflux patterns of different positions with endoscopic severity of gastroesophageal reflux disease(GERD).【Methods】Ninety-one cases of GERD were divided into two groups according to the endoscopic reflux esophagitis or pathological results of 24-hour esophageal pH monitoring:non-erosive reflux disease(NERD)(n=50) and erosive esophagitis(EE)(n=41).The esophageal pH parameters in the upright versus supine positions were compared between two groups and compared among patients with various severity grades of reflux esophagitis.【Results】The index values of supine acid reflux in NERD group such as number of reflux episodes,number of reflux episodes of more than 5 min duration,duration of longest reflux episode,percentage of time pH<4 were 12.5(0~68),0(0~8),5(0~53),2(0~24.7),respectively,significantly lower than those of EE,27(0~246),1(0~11),10(0~102),5.4(0~72) respectively(P<0.05),there were no differences in the index values of upright acid reflux between two groups studied.The supine values of number of reflux episodes and percentage of time pH<4 in patients with grade C esophagitis(Los Angeles classification) were significantly higher than those in patients with grade A and grade B esophagitis.【Conclusion】Supine reflux is in relation to the development and severity of esophageal injury.更多还原