Cresi F, de Sanctis L, Savino F, Bretto R, Testa A, Silvestro L
Neonatal Care Unit, Regina Margherita Children's Hospital, University of Turin, Turin, Italy.
Neurogastroenterol Motil. 2006 May;18(5):361-8. doi: 10.1111/j.1365-2982.2006.00769.x.
The pathogenesis of gastro-oesophageal reflux disease (GORD) is complex and multifactorial. A motility disorder resulting from immaturity of the gastro-oesophageal tract may be involved. We have combined multichannel intraluminal impedance (MII) and pH monitoring with epigastric impedance (EGI) to evaluate the activity of this tract in neonates with suspected GORD. Multichannel intraluminal impedance, pH and EGI were followed for 3 h in 30 newborns displaying apparent life-threatening events and signs of GORD. Simultaneous application of MII and pH monitoring identifies reflux episodes and illustrates their duration, height and pH. Episodes detected by MII were placed on the EGI curve and the contemporaneous gastric filling state and emptying velocity were calculated. During the total measuring time, 248 reflux episodes were revealed. An inverse correlation was evident for reflux frequency and gastric emptying velocity (r2 = 0.94; P < 0.001), and between acid refluxes and the gastric filling state (r2 = 0.95; P < 0.001), whereas a positive correlation was found between the reflux level and the gastric filling state (r2 = 0.52; P < 0.05). Simultaneous MII, pH and EGI monitoring provided new information on the relationship between refluxes and gastric activity. Data suggest that gastric emptying patterns influence the frequency, level and pH of reflux episodes.
胃食管反流病（GORD）的发病机制复杂且具有多因素性。可能涉及因胃食管 tract 不成熟导致的动力障碍。我们将多通道腔内阻抗（MII）和pH监测与上腹部阻抗（EGI）相结合，以评估疑似GORD的新生儿中该 tract 的活动情况。对30名出现明显危及生命事件和GORD体征的新生儿进行了3小时的多通道腔内阻抗、pH和EGI监测。同时应用MII和pH监测可识别反流发作，并说明其持续时间、高度和pH值。将MII检测到的发作置于EGI曲线上，并计算同期胃充盈状态和排空速度。在整个测量期间，共发现248次反流发作。反流频率与胃排空速度呈负相关（r2 = 0.94；P < 0.001），酸反流与胃充盈状态呈负相关（r2 = 0.95；P < 0.001），而反流水平与胃充盈状态呈正相关（r2 = 0.52；P < 0.05）。同时进行MII、pH和EGI监测为反流与胃活动之间的关系提供了新信息。数据表明，胃排空模式会影响反流发作的频率、水平和pH值。
