Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
Aliment Pharmacol Ther. 2010 Sep;32(6):795-800. doi: 10.1111/j.1365-2036.2010.04397.x.
The pathogenesis of gastro-oesophageal reflux disease includes increased acid reflux, reduced salivation and impaired peristalsis. This may depend upon the height of acid wave and magnitude of oesophageal mucosal exposure. Interestingly, the effect of site of acid infusion upon salivary secretion and heartburn has not been examined in any detail.
To examine whether acid infusion in the upper oesophagus may cause increased salivation and heartburn as compared with acid infusion in the lower oesophagus.
Twelve healthy male subjects (mean age 30) received infusions of HCl, citric acid and acetic acid at 10 and 20 cm above the lower oesophageal sphincter (LES) for fixed time periods. Parotid saliva collected periodically and heartburn severity scored using standardized scale. Standard statistical methods (paired t-tests, analysis of variance) were used to determine the significance of results.
Acid infusion in the upper oesophagus increased parotid flow rate as compared with that in the lower oesophagus (P < 0.05). Likewise, there was a significantly increased heartburn score at 20 cm as well as 10 cm above LES (P < 0.05) as compared with that in the stomach.
These data suggest a significant increase in salivation and heartburn in response to acid infusion in the upper vs. lower part of the oesophagus.
胃食管反流病的发病机制包括胃酸反流增加、唾液分泌减少和蠕动功能障碍。这可能取决于酸波的高度和食管黏膜暴露的程度。有趣的是，酸灌注部位对唾液分泌和烧心的影响尚未得到详细研究。
研究与食管下段相比，酸在上段食管灌注是否会引起唾液分泌增加和烧心。
12 名健康男性受试者（平均年龄 30 岁）在下食管括约肌（LES）上方 10 和 20 cm 处接受 HCl、柠檬酸和乙酸的灌注，持续固定时间。周期性收集腮腺唾液并使用标准化量表评分烧心严重程度。采用标准统计方法（配对 t 检验、方差分析）确定结果的显著性。
与食管下段相比，在上段食管灌注酸可增加腮腺分泌率（P<0.05）。同样，在上段食管 LES 上方 20 cm 和 10 cm 处的烧心评分也明显高于胃内灌注（P<0.05）。
这些数据表明，与食管下段相比，酸在上段食管灌注会引起明显的唾液分泌增加和烧心。
