Department of Clinical and Experimental Medicine, Postgraduate School of Gastroenterology, University of Ferrara, Ferrara, Italy.
Obes Surg. 2011 Jan;21(1):48-53. doi: 10.1007/s11695-010-0275-z.
The 24-h ambulatory pH-metry with multichannel intraluminal impedance monitoring (24-h pH-metry+MII) allows the simultaneous assessment of chemical and physical properties of esophageal refluxes and the detection of its proximal migration.
Gastroesophageal reflux (GER) was investigated in obese symptomatic (obese gastroesophageal reflux disease, GERD) and asymptomatic (obese non-GERD) patients. The data were compared with those obtained from non-obese GERD patients and a control group. Thirty-five (20 non-GERD, 15 GERD) obese patients and 15 non-obese GERD were investigated with 24-h pH-metry+MII. Ten normal weight subjects with normal 24-h pH-metry+MII were used as control group.
The percent time acid exposure was significantly higher in obese non-GERD than controls (p = 0.007). Acid reflux episodes were increased vs. controls in obese non-GERD (p = 0.005) and obese GERD (p = 0.034). Upright position showed a significant increase of reflux episodes in non-obese GERD (p = 0.034) and in obese non-GERD (p = 0.027) vs. controls. Recumbent position showed reflux episodes significantly increased vs. controls in obese non-GERD (p = 0.002), obese GERD (p = 0.021), and non-obese GERD (p = 0.033). In obese non-GERD, waist circumference (WC) correlated negatively with upright position episodes (r = -0.53; p = 0.043) and with proximal migration episodes, i.e., total (r = -0.60; p = 0.018), acid (r = -0.55; p = 0.033), and weakly acidic refluxes (r = -0.56; p = 0.031).
Obese patients showed an increased number of refluxes with acid content. Refluxes with proximal extent were significantly higher in obese non-GERD than in controls and non-obese GERD patients. No difference was observed between the two obese patient groups. In asymptomatic obese patients, the WC correlated with proximal extent episodes.
24 小时动态 pH 监测联合多通道腔内阻抗监测（24 小时 pH 监测+MII）可同时评估食管反流的化学和物理特性，并检测其近端迁移。
对肥胖有症状（肥胖胃食管反流病，GERD）和无症状（肥胖非 GERD）患者进行胃食管反流（GER）研究。将数据与非肥胖 GERD 患者和对照组的数据进行比较。对 35 名（20 名非 GERD，15 名 GERD）肥胖患者和 15 名非肥胖 GERD 患者进行了 24 小时 pH 监测+MII 检查。10 名体重正常、24 小时 pH 监测+MII 正常的受试者作为对照组。
肥胖非 GERD 患者的酸暴露时间百分比明显高于对照组（p=0.007）。与对照组相比，肥胖非 GERD（p=0.005）和肥胖 GERD（p=0.034）患者的酸反流发作次数增加。直立位时，非肥胖 GERD（p=0.034）和肥胖非 GERD（p=0.027）与对照组相比，反流发作次数显著增加。卧位时，肥胖非 GERD（p=0.002）、肥胖 GERD（p=0.021）和非肥胖 GERD（p=0.033）患者的反流发作次数明显高于对照组。在肥胖非 GERD 患者中，腰围（WC）与直立位发作次数呈负相关（r=-0.53；p=0.043），与近端迁移发作次数呈负相关，即总发作次数（r=-0.60；p=0.018）、酸反流发作次数（r=-0.55；p=0.033）和弱酸性反流发作次数（r=-0.56；p=0.031）。
肥胖患者的酸反流次数增加。与对照组和非肥胖 GERD 患者相比，肥胖非 GERD 患者的近端延伸反流明显更高。两组肥胖患者之间无差异。在无症状肥胖患者中，WC 与近端延伸发作次数相关。
