Freidin N, Mittal R K, McCallum R W
Department of Internal Medicine, University of Virginia, Charlottesville.
Gut. 1991 Feb;32(2):133-6. doi: 10.1136/gut.32.2.133.
We studied eight patients with gastro-oesophageal reflux disease to compare the frequency and mechanism of reflux in the upright and supine positions. Simultaneous oesophageal manometry and pH studies were performed on two separate days in each subject in the fasting and postprandial periods. The frequency of reflux tended to be higher in the upright position. The most prevalent mechanism of reflux in either position was transient relaxation of the lower oesophageal sphincter. The frequency of transient lower oesophageal sphincter relaxation was higher in the upright than in the supine position. There was no difference in the total reflux time, acid clearance time, and number of reflux episodes lasting longer than five minutes in the two positions. We suggest that daytime reflux (upright) may be as important as night time (supine) reflux in the pathogenesis of reflux oesophagitis and needs to be considered when treating patients with reflux disease.
我们研究了8例胃食管反流病患者，以比较直立位和仰卧位时反流的频率和机制。在每个受试者的空腹和餐后阶段，于两个不同日期同时进行食管测压和pH值研究。直立位时反流频率往往更高。在任一位置，最常见的反流机制是食管下括约肌的一过性松弛。食管下括约肌一过性松弛的频率在直立位高于仰卧位。两个位置的总反流时间、酸清除时间以及持续超过5分钟的反流发作次数均无差异。我们认为，日间反流（直立位）在反流性食管炎的发病机制中可能与夜间反流（仰卧位）同样重要，在治疗反流病患者时需要加以考虑。
