Grigolon Ausilia, Cantú Paolo, Bravi Ivana, Caparello Chiara, Penagini Roberto
Cattedra di Gastroenterologia, Dipartimento di Scienze Mediche, Università degli Studi of Milan, Milan, Italy.
Am J Gastroenterol. 2009 Nov;104(11):2714-20. doi: 10.1038/ajg.2009.443. Epub 2009 Jul 28.
After meals, highly acidic gastric juice is present in the subcardial region, the so-called acid pocket. Patients with gastroesophageal reflux disease (GERD) have a higher frequency of acidic reflux. Our aim was to investigate the possible differences in subcardial pH in GERD over 24 h and the role of hiatal hernia (HH), using a wireless capsule.
A total of 14 healthy volunteers (4 men, 24-60 years), 10 GERD patients without HH (4 men, 25-68 years), and 11 GERD patients with HH >or=3 cm (2 men, 46-74 years) underwent 24-h wireless pH monitoring 2 cm below the squamocolumnar junction. All patients had increased 24-h acid reflux. A standardized lunch was given to all study subjects.
No capsule detached during the 24-h recording. Median 24-h pH was similar in healthy subjects, and in patients without and with HH, median: 1.4 (interquartile range: 1.2 -1.9), 1.5 (1.3 -1.7), and 1.4 (1.3 -1.7), respectively. Similar results were seen in the supine period. Median pH after the standardized meal was often highly acidic, 2.7 (1.5 - 3.2), 1.9 (1.6 - 2.3), and 2.5 (1.6 - 3.2), respectively. The first minute with a median pH <2 occurred 14 min (4 - 49), 14 min (6 - 25), and 20 min (4 - 43), respectively, P=NS, after the end of the meal. Similar data were observed on pooling all meals together.
Subcardial pH is confirmed to be highly acidic early after meals, but it is similar over 24 h in healthy subjects and GERD patients independent of the presence of HH.
餐后，贲门下方区域即所谓的酸袋中存在高酸性胃液。胃食管反流病（GERD）患者酸性反流的频率更高。我们的目的是使用无线胶囊研究GERD患者24小时内心脏下pH值的可能差异以及食管裂孔疝（HH）的作用。
共有14名健康志愿者（4名男性，24 - 60岁）、10名无HH的GERD患者（4名男性，25 - 68岁）和11名HH≥3 cm的GERD患者（2名男性，46 - 74岁）在鳞柱状交界处下方2 cm处进行了24小时无线pH监测。所有患者24小时酸反流均增加。所有研究对象均给予标准化午餐。
在24小时记录期间没有胶囊脱落。健康受试者、无HH和有HH的患者的24小时pH中位数相似，分别为：1.4（四分位间距：1.2 - 1.9）、1.5（1.3 - 1.7）和1.4（1.3 - 1.7）。仰卧期也观察到类似结果。标准化餐后的pH中位数通常呈高酸性，分别为2.7（1.5 - 3.2）、1.9（1.6 - 2.3）和2.5（1.6 - 3.2）。餐后结束后，pH中位数<2的第一分钟分别出现在14分钟（4 - 49）、14分钟（6 - 25）和20分钟（4 - 43），P =无显著性差异。将所有餐食汇总后观察到类似数据。
餐后早期心脏下pH值被证实呈高酸性，但在健康受试者和GERD患者中，无论是否存在HH，24小时内该值相似。
