研究夜间胃食管反流与睡眠的外科试验（STINGERS）
Surgical trial investigating nocturnal gastroesophageal reflux and sleep (STINGERS).
作者信息
Cohen J A, Arain A, Harris P A, Byrne D W, Holzman M D, Sharp K W, Richards W O
机构信息
Section of Surgical Sciences, Division of General Surgery, Vanderbilt University, MCN D-5219, Nashville, TN 37232-2905, USA.
出版信息
Surg Endosc. 2003 Mar;17(3):394-400. doi: 10.1007/s00464-002-8912-9. Epub 2002 Nov 20.
BACKGROUND
Nocturnal reflux is important in the pathogenesis of esophagitis. The relationship between reflux and sleep is poorly understood, although data support both paradigms of nocturnal reflux causing arousal and nocturnal arousal allowing reflux. Furthermore, the effect of fundoplication on sleep is unknown.
METHODS
Seven volunteers and 11 patients with gastroesophageal reflux disease (GERD) and nocturnal symptoms were studied with esophageal pH and polysomnography at baseline and at 8 to 10 weeks follow-up evaluation, with patients undergoing interval fundoplication. Gastrointestinal and sleep questionnaires were completed before each study.
RESULTS
Questionnaire data between the groups showed differences at baseline, which were eliminated by surgery. No objective differences in sleep were observed between the groups at baseline or at follow-up evaluation. However, the patient group significantly increased the fraction of the night spent in deeper sleep (49.6% vs 58.3%; p = 0.022). Reflux events were associated with arousals in sleep.
CONCLUSIONS
Fundoplication improves both subjective and objective sleep quality in patients with nocturnal GERD symptoms.
背景
夜间反流在食管炎的发病机制中具有重要作用。尽管有数据支持夜间反流导致觉醒以及夜间觉醒引发反流这两种模式，但反流与睡眠之间的关系仍未被充分理解。此外，胃底折叠术对睡眠的影响尚不清楚。
方法
对7名志愿者和11名有胃食管反流病（GERD）及夜间症状的患者进行研究，在基线期以及8至10周的随访评估时进行食管pH值监测和多导睡眠图监测，患者接受了间隔性胃底折叠术。在每次研究前完成胃肠道和睡眠问卷调查。
结果
两组之间的问卷调查数据在基线期存在差异，手术消除了这些差异。在基线期或随访评估时，两组之间未观察到睡眠方面的客观差异。然而，患者组深度睡眠占夜间的比例显著增加（49.6%对58.3%；p = 0.022）。反流事件与睡眠中的觉醒相关。
结论
胃底折叠术可改善有夜间GERD症状患者的主观和客观睡眠质量。
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