Chen Chien-Lin, Orr William C
Lynn Health Science Institute, Oklahoma University Health Sciences Center, Oklahoma City, OK 73112, USA.
Curr Gastroenterol Rep. 2008 Jun;10(3):258-62. doi: 10.1007/s11894-008-0053-4.
This review addresses current advances in the diagnosis of sleep-related gastroesophageal reflux using ambulatory esophageal pH monitoring and laboratory monitoring, which includes polygraphic assessment of the state of consciousness. This 24-hour pH monitoring uses a new strategy of interpretation that characterizes acidic reflux events and specifically assesses the patient's position and state of consciousness. Thus, the recognition of reflux events during waking and sleep will add to the overall assessment of gastroesophageal reflux and its severity and clinical relevance. The pH testing, together with overnight polysomnography, offers an opportunity to link nighttime reflux with disease severity. The application of multichannel impedance with pH monitoring allows detection of acidic and nonacidic reflux events during sleep and also helps to elucidate the physiologic response of the esophagus to these events during sleep. The significance of these findings will increase our knowledge of esophageal physiology and the pathologic mechanisms underlying gastroesophageal reflux disease.
本综述探讨了使用动态食管pH监测和实验室监测（包括对意识状态的多导睡眠图评估）在睡眠相关胃食管反流诊断方面的当前进展。这种24小时pH监测采用了一种新的解读策略，该策略可对酸性反流事件进行特征描述，并专门评估患者的体位和意识状态。因此，识别清醒和睡眠期间的反流事件将有助于对胃食管反流及其严重程度和临床相关性进行全面评估。pH检测与夜间多导睡眠图一起，为将夜间反流与疾病严重程度联系起来提供了机会。多通道阻抗与pH监测的应用能够检测睡眠期间的酸性和非酸性反流事件，也有助于阐明睡眠期间食管对这些事件的生理反应。这些发现的意义将增加我们对食管生理学以及胃食管反流病潜在病理机制的认识。
