Postprandial proximal gastric acid pocket and its association with gastroesophageal acid reflux in patients with short-segment Barrett’s esophagus  

短节段Barrett’s食管的胃食管酸反流与餐后近端胃酸袋的相关性研究

作　　者：Yuan-yuan NIAN Xian-mei MENG Jing WU Fu-chu JING Xue-qin WANG Tong DANG Jun ZHANG 

机构地区：[1]Department of Gastroenterology,the Second Affiliated Hospital of Baotou Medical College,Baotou 014040,China [2]Department of Gastroenterology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710049,China

出　　处：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》2020年第7期581-589,共9页浙江大学学报（英文版）B辑（生物医学与生物技术）

基　　金：Project supported by the Natural Science Foundation of Inner Mongolia Autonomous Region(Nos.2019LH08042 and 2018MS08050);the Natural Science Foundation of Baotou Medical College(No.BYJJ-YF-2018024),China。

摘　　要：Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patients with BE(defined by columnar lined esophagus of≥1 cm)and 15 healthy individuals that were matched for age,gender,and body mass index,were recruited.The fasting intragastric p H and the appearance time,length,lowest p H,and mean p H of the PPGAP were determined using a single p H electrode pull-through experiment.For BE patients,a gastroesophageal reflux disease questionnaire(Gerd Q)was completed and esophageal 24-h p H monitoring was carried out.Results:The PPGAP was significantly longer(5(3,5)cm vs.2(1,2)cm)and the lowest p H(1.1(0.8,1.5)vs.1.6(1.4,1.9))was significantly lower in patients with short-segment BE than in healthy individuals.The PPGAP started to appear proximally from the gastroesophageal p H step-up point to the esophageal lumen.The acidity of the PPGAP was higher in the distal segment than in the proximal segment.In short-segment BE patients,there were significant correlations between the acidity and the appearance time and length of the PPGAP.The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes.The acidity of the PPGAP was associated with the De Meester scores,the Gerd Q scores,and the fasting intragastric p H.Conclusions:In patients with short-segment BE,a PPGAP is commonly seen.Its length and acidity of PPGAP are associated with gastroesophageal acid reflux,the De Meester score,and the Gerd Q score in patients with short-segment BE.目的:检测并分析短节段Barrett’s食管(BE)患者的餐后近端胃酸袋(PPGAP)的特点,并分析其与胃食管酸反流的相关性。创新点:PPGAP可能是胃食管反流病的病理因素之一,引起广泛关注,而BE患者的PPGAP特点及与反流的相关性尚无报道。方法:15名短节段BE患者和15名健康志愿者分别以牵拉法检测PPGAP的发生时间、长度、最低pH值和平均pH值。BE患者完成Gerd Q问卷调查和24 h食管pH监测。结论:短节段BE患者普遍存在PPGAP,同时PPGAP的长度和酸度与其胃食管酸反流周期数、De Meester评分和Gerd Q评分具有相关性。

关 键 词：Short-segment Barrett’s esophagus Postprandial proximal gastric acid pocket(PPGAP) Gastroesophageal acid reflux 

分 类 号：R571[医药卫生—消化系统]