Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System and University of Arizona, 3601 South Sixth Avenue, Tucson, AZ 85723-0001, USA.
Nat Rev Gastroenterol Hepatol. 2011 Feb;8(2):101-7. doi: 10.1038/nrgastro.2010.212.
Ambulatory 24 h esophageal pH monitoring enables quantification of esophageal acid exposure and assessment of the temporal relationship between symptoms and acid reflux events. Analysis of pH monitoring is currently divided into upright and recumbent periods based on the patient's body position. However, in this Review, we demonstrate that physiologic studies have shown that sleep, and not recumbency, has a greater impact on gastroesophageal reflux during night-time. The physiologic studies are further supported by clinical trials demonstrating that gastroesophageal reflux characteristics during the recumbent-awake period are similar to those in the upright rather than the recumbent-asleep period. The introduction of the integrated pH monitoring and actigraphy data analysis program offers better separation of the recumbent-awake and recumbent-asleep periods. The physiologic studies and clinical trials, as well as the availability of a better tool to measure pH during sleep, support a paradigm shift in the analysis of pH monitoring data from body position (upright or recumbent) to state of consciousness (awake or asleep).
动态 24 h 食管 pH 监测可定量评估食管酸暴露，并评估症状与酸反流事件之间的时间关系。目前，pH 监测分析根据患者的体位分为直立位和卧位期。然而，在这篇综述中，我们证明，生理研究表明，睡眠而非卧位对夜间胃食管反流的影响更大。生理研究进一步得到临床试验的支持，这些试验表明，卧位-清醒期的胃食管反流特征与直立位而非卧位-睡眠期相似。集成 pH 监测和活动记录仪数据分析程序的引入，更好地分离了卧位-清醒期和卧位-睡眠期。生理研究、临床试验以及更好的睡眠期间 pH 测量工具的出现，支持 pH 监测数据分析从体位（直立或卧位）向意识状态（清醒或睡眠）转变的范式转变。
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