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

作　　者：王芳薇[1] 张伯伦[1] 

机构地区：[1]大连医科大学第二临床学院消化内科,辽宁大连116027

出　　处：《大连医科大学学报》2007年第1期48-50,共3页Journal of Dalian Medical University

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 m in的次数(number of reflux lasting more than five m inutes,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 m in)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。[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, acid secretion levels were studied which were basic acid output （ 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 BE （ Ⅳdegree RE） partly or entirely showed higher acid NR5 pattern （pH ≤2 and over 5 minutes）. Thirty five percent of patients with Ⅰ degree - Ⅲ degree 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 - mdegree RE or for health subjects. [Conclusion] higher acid mode of NR5 plays an important role in the pathogenesis of serious RE.

关 键 词：反流性食管炎 24h动态食管pH监测 胃液分析 

分 类 号：R571[医药卫生—消化系统]