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通过阻抗-pH 监测重新评估夜间胃食管反流。

Nocturnal gastroesophageal reflux revisited by impedance-pH monitoring.

机构信息

Center for Gastroenterological Research, Catholic University of Leuven, Belgium.

出版信息

J Neurogastroenterol Motil. 2011 Apr;17(2):148-57. doi: 10.5056/jnm.2011.17.2.148. Epub 2011 Apr 27.

DOI:10.5056/jnm.2011.17.2.148
PMID:21602991
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3093006/
Abstract

BACKGROUND/AIMS: Impedance-pH monitoring allows detailed characterization of gastroesophageal reflux and esophageal activity associated with reflux. We assessed the characteristics of nocturnal reflux and esophageal activity preceding and following reflux.

METHODS

Impedance-pH tracings from 11 healthy subjects and 76 patients with gastroesophageal reflux disease off acid-suppressive therapy were analyzed. Characteristics of nocturnal supine reflux, time distribution and esophageal activity seen on impedance at 2 minute intervals preceding and following reflux were described.

RESULTS

Patients had more nocturnal reflux events than healthy subjects (8 [4-12] vs 2 [1-5], P = 0.002), with lower proportion of weakly acidic reflux (57% [35-78] vs 80% [60-100], P = 0.044). Nocturnal reflux was mainly liquid (80%) and reached the proximal esophagus more often in patients (6% vs 0%, P = 0.047). Acid reflux predominated in the first 2 hours (66%) and weakly acidic reflux in the last 3 hours (70%) of the night. Most nocturnal reflux was preceded by aboral flows and cleared by short lasting volume clearance. In patients, prolonged chemical clearance was associated with less esophageal activity.

CONCLUSIONS

Nocturnal weakly acidic reflux is as common as acid reflux in patients with gastroesophageal reflux disease, and predominates later in the night. Impedance-pH can predict prolonged chemical clearance after nocturnal acid reflux.

摘要

背景/目的：阻抗-pH 监测可详细描述胃食管反流和与反流相关的食管活动。我们评估了夜间反流和反流前后食管活动的特征。

方法

分析了 11 名健康受试者和 76 名接受胃酸抑制治疗的胃食管反流病患者的阻抗-pH 轨迹。描述了夜间仰卧反流的特征、在反流前 2 分钟和反流后每隔 2 分钟观察到的阻抗时的时间分布和食管活动。

结果

与健康受试者相比，患者夜间反流事件更多（8 [4-12] 次 vs 2 [1-5] 次，P = 0.002），弱酸性反流比例较低（57% [35-78] vs 80% [60-100]，P = 0.044）。夜间反流主要为液体（80%），在患者中更常到达近端食管（6% vs 0%，P = 0.047）。酸反流在前 2 小时（66%）占主导地位，弱酸性反流在后 3 小时（70%）占主导地位。大多数夜间反流之前是逆行流，通过短暂的容量清除来清除。在患者中，长时间的化学清除与食管活动减少有关。

结论

在胃食管反流病患者中，夜间弱酸性反流与酸反流一样常见，并且在夜间后期更为常见。阻抗-pH 可预测夜间酸反流后的化学清除时间延长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/93eb22347594/jnm-17-148-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/5d67848cc56b/jnm-17-148-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/75f94617d80d/jnm-17-148-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/596a6221f353/jnm-17-148-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/3733f1aa6f9c/jnm-17-148-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/93eb22347594/jnm-17-148-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/5d67848cc56b/jnm-17-148-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/75f94617d80d/jnm-17-148-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/596a6221f353/jnm-17-148-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/3733f1aa6f9c/jnm-17-148-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a3/3093006/93eb22347594/jnm-17-148-g005.jpg

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