Pasricha P Jay
Division of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston 77059, USA.
Am J Med. 2003 Aug 18;115 Suppl 3A:114S-118S. doi: 10.1016/s0002-9343(03)00208-0.
The sleeping state is accompanied by many changes in gastroesophageal function that may be of importance in the pathogenesis of gastroesophageal reflux disease (GERD). At nighttime, gastric acid production is increased, gastric emptying is delayed, esophageal clearance is markedly delayed, and upper esophageal sphincter pressure diminishes significantly. Further, unlike daytime esophageal acid exposure, which appears more easily controlled with medical treatment, nocturnal gastric acid production appears difficult to suppress pharmacologically. Nighttime reflux may be associated with a greater prevalence of supraesophageal reflux symptoms as well. At the same time, protective airway reflexes may limit esophageal reflux in some patients. Derangements in the protective mechanisms should be elucidated, as these might account for susceptibility to GERD in patients with nighttime reflux.
睡眠状态伴随着胃食管功能的许多变化，这些变化可能在胃食管反流病（GERD）的发病机制中具有重要意义。夜间，胃酸分泌增加，胃排空延迟，食管清除明显延迟，食管上括约肌压力显著降低。此外，与白天的食管酸暴露不同，白天的食管酸暴露似乎更容易通过药物治疗得到控制，而夜间胃酸分泌似乎难以通过药物抑制。夜间反流也可能与食管外反流症状的更高发生率相关。同时，保护性气道反射可能会在一些患者中限制食管反流。应阐明保护机制的紊乱情况，因为这些可能解释了夜间反流患者对GERD的易感性。
