Sifrim D, Holloway R, Silny J, Tack J, Lerut A, Janssens J
Center for Gastroenterological Research, Catholic University of Leuven, Belgium.
Am J Gastroenterol. 2001 Mar;96(3):647-55. doi: 10.1111/j.1572-0241.2001.03598.x.
It is not known whether the characteristics of the postprandial refluxate in patients with gastroesophageal reflux disease (GERD) differ from those observed in normal subjects. The aim of this study was to characterize the postprandial refluxate in adult patients with GERD using combined intraluminal electrical impedance and pH measurements.
Postprandial gastroesophageal reflux was assessed in 16 patients with GERD and 15 controls. pH and intraluminal electrical impedance were used to identify acid and nonacid reflux of liquid, mixed (liquid + gas) or gas.
Transient lower esophageal sphincter relaxations (TLESRs) and reflux of gastric contents were equally frequent in both groups. However, patients with GERD had more acid reflux [8 (4.7-10.5)/h vs 3.5 (2.6-6)/h, p < 0.05], and normal subjects had more nonacid reflux [5 (4.3-6.7)/h is 3 (1-3.5)/h, p < 0.05]. Gas reflux was less frequent in GERD than in controls (51% vs 68%; p < 0.05). Pure liquid reflux, however, was more frequent (40% vs 26%, p < 0.05) and twice as likely to be acid in GERD. During TLESRs, liquid acid reflux was more frequent in GERD than in controls.
TLESRs and reflux of gastric contents are similarly frequent in patients with GERD and controls. However, patients with GERD have more acid reflux and less nonacid reflux. Differences in the air-liquid composition of the refluxate may contribute to the higher rate of acid reflux observed in these patients.
尚不清楚胃食管反流病（GERD）患者餐后反流物的特征是否与正常受试者不同。本研究的目的是使用腔内电阻抗和pH联合测量来描述成年GERD患者的餐后反流物特征。
对16例GERD患者和15例对照者进行餐后胃食管反流评估。使用pH和腔内电阻抗来识别液体、混合（液体+气体）或气体的酸反流和非酸反流。
两组患者的一过性下食管括约肌松弛（TLESRs）和胃内容物反流频率相同。然而，GERD患者的酸反流更多[8（4.7 - 10.5）次/小时 vs 3.5（2.6 - 6）次/小时，p < 0.05]，而正常受试者的非酸反流更多[5（4.3 - 6.7）次/小时 vs 3（1 - 3.5）次/小时，p < 0.05]。GERD患者的气体反流比对照组少（51% vs 68%；p < 0.05）。然而，纯液体反流更频繁（40% vs 26%，p < 0.05），且在GERD患者中酸反流的可能性是对照组的两倍。在TLESRs期间，GERD患者的液体酸反流比对照组更频繁。
GERD患者和对照组的TLESRs和胃内容物反流频率相似。然而，GERD患者的酸反流更多，非酸反流更少。反流物气液成分的差异可能导致这些患者中观察到的较高酸反流率。
