Budzyński J, Swiatkowski M, Kłopocka M, Fabisiak J, Bujak R, Sinkiewicz W
Klinika Gastroenterologii i Chorób Wewnetrznych AM w Bydgoszczy.
Pol Arch Med Wewn. 2000 Mar-Apr;103(3-4):133-8.
Changes in intraesophageal pH can influence myocardium perfusion via neural reflexes. The aim of this study was to estimate the relationships between intraesophageal pH and the course of electrocardiographic exercise test. 38 male patients with atypical chest pain in mean age 41.1 +/- 7.8 years were studied. In all among other 24-hours oesophageal pH monitoring and exercise test on running track with simultaneous oesophageal pH monitoring were made. Pathological acid reflux in 24-hours monitoring had 11 (29%) patients, exertional acid gastroesophageal reflux in 8 (21%) patients was found and significant ST interval depression in ecg in 11 (29%) patients was observed. The differences in patients quantity in respective subgroups were not significant. Patients with significant ST interval depression during exercise test, in comparison with patients without significant ecg changes, had lower HDL cholesterol level and higher values of daily and exertional gastroesophageal acid reflux parameters. Multiple-regression analysis showed that indicators of functional (pH-metry) and morphological (endoscopy and histology) oesophageal status were the independent factors determining variance of: exercise test duration, percentage of maximal heart rate during exercise test, double product value and maximal ST interval depression. In conclusion, changes in intraesophageal pH can influence exercise test course.
食管内pH值的变化可通过神经反射影响心肌灌注。本研究的目的是评估食管内pH值与心电图运动试验过程之间的关系。对38例平均年龄为41.1±7.8岁的非典型胸痛男性患者进行了研究。所有患者均进行了24小时食管pH监测以及在跑道上进行的运动试验并同时监测食管pH值。在24小时监测中，11例（29%）患者存在病理性酸反流，8例（21%）患者存在运动性酸胃食管反流，11例（29%）患者心电图出现明显的ST段压低。各亚组患者数量的差异无统计学意义。与心电图无明显变化的患者相比，运动试验期间ST段明显压低的患者高密度脂蛋白胆固醇水平较低，每日和运动性胃食管酸反流参数值较高。多元回归分析表明，食管功能（pH测量）和形态（内镜检查和组织学）状态指标是决定运动试验持续时间、运动试验期间最大心率百分比、双乘积值和最大ST段压低变化的独立因素。总之，食管内pH值的变化可影响运动试验过程。
