【摘要】 目的探讨自主神经功能障碍在胃食管反流病(GERD)发病中的作用。方法采用心血管反射检测自主神经的功能状态;根据自主神经功能评价结果,进一步分析自主神经受累程度与食管动力、反流性食管炎的程度及反流症状之间的关系。结果①GERD患者中自主神经功能异常者达59.5%,尤以副交感神经受累为著;②GERD患者中自主神经功能正常组反流症状积分明显低于异常组(P<0.05),自主神经受累的程度与反流症状积分呈显著的正相关(r=0.54,P<0.05);③GERD患者中自主神经异常组食管远端有效收缩率及传导速度明显低于正常组(P<0.05)。结论GERD患者存在明显的自主神经功能异常,而且自主神经功能状态与食管远端的清除能力和反流症状有关,提示自主神经功能障碍在GERD发病中起着一定的作用。更多还原

【Abstract】 Objective To investigate the effect of autonomic nervous dysfunction on pathogenesis of gastro-esophageal reflux disease(GERD).Methods Autonomic nervous function(ANF) was assessed by cardiovascular reflex tests in healthy volunteers and patients with GERD;Based on the ANF test results,the relationship between the impairment degree of autonomic nerve and the esophageal motility or the reflux esophagitis or the score of reflux symptoms was investigated.Results ① 59.5% of patients with GERD have abnormal ANF and the rate in GERD patients is much higher than that in healthy volunteers,parasympathetic nerve impairment is predominant.② The score of reflux symptoms in patients with normal ANF is significantly lower than that in patients with abnormal ANF(6(2,7.6)vs 9(4.1,17),P<0.05),there is a significant positive correlation between impairment degree of ANF and the score of reflux symptoms(r=0.54,P<0.05);③ The effective contraction rate(61.2% vs 54.5%,(P<0.05)) and conduction velocity(2.95±(0.45 cm/s) vs 1.76±(0.68 cm/s),P<0.05) of distal esophagus of patients with abnormal ANF were significantly lower than that in patients with normal ANF.Conclusions ANS is significantly abnormal in patients with GERD.ANF condition is related to the clearance ability of distal esophagus and the score of reflux symptoms,suggesting that autonomic nervous dysfunction plays an important role in the pathogenesis of gastro-esophageal reflux disease.更多还原