Ireland A C, Dent J, Holloway R H
Department of Gastrointestinal Medicine, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
Gut. 1999 Mar;44(3):313-6. doi: 10.1136/gut.44.3.313.
In normal subjects, transient lower oesophageal sphincter relaxations (TLOSRs) and gas reflux during belching are suppressed in the supine position. Supine reflux, however, is a feature of reflux disease.
To investigate whether postural suppression of TLOSRs and gas reflux is impaired in patients with reflux disease.
Ten patients with erosive oesophagitis.
Oesophageal manometry was performed during gastric distension with 750 ml carbon dioxide. Measurements were made for 10 minutes before and after distension in both sitting and supine positions.
In the sitting position gastric distension substantially increased the rate of gas reflux (median (interquartile range)), as evidenced by increases in oesophageal common cavities from 1 (0-1)/10 min to 7 (5-10)/10 min and TLOSRs from 1 (1-1.5)/10 min to 6 (2.5-8)/10 min. However, this effect was suppressed in the supine position in all but one patient (TLOSRs 0 (0)/10 min to 1 (0-4.5)/10 min, common cavities 0 (0)/10 min to 0.5 (0-2)/10 min).
Postural suppression of TLOSRs and gas reflux is generally preserved in reflux disease.
在正常受试者中，嗳气时短暂性下食管括约肌松弛（TLOSRs）和气体反流在仰卧位时受到抑制。然而，仰卧位反流是反流性疾病的一个特征。
研究反流性疾病患者中TLOSRs和气体反流的体位抑制是否受损。
10例糜烂性食管炎患者。
用750毫升二氧化碳使胃扩张时进行食管测压。在扩张前后分别于坐位和仰卧位测量10分钟。
在坐位时，胃扩张显著增加了气体反流率（中位数（四分位间距）），食管共同腔从1（0 - 1）/10分钟增加到7（5 - 10）/10分钟，TLOSRs从1（1 - 1.5）/10分钟增加到6（2.5 - 8）/10分钟，这证明了这一点。然而，除1例患者外，所有患者在仰卧位时这种效应均受到抑制（TLOSRs从0（0）/10分钟增加到1（0 - 4.5）/10分钟，共同腔从0（0）/10分钟增加到0.5（0 - 2）/10分钟）。
反流性疾病中TLOSRs和气体反流的体位抑制通常得以保留。
