Arsene D, Bruley des Varannes S, Galmiche J P, Denis P, Chayvialle J A, Hellot M F, Ducrotte P, Colin R
J Hepatol. 1987 Apr;4(2):250-8. doi: 10.1016/s0168-8278(87)80088-0.
The oesophageal pH was recorded for 3 h after a test-meal in 27 healthy control subjects (group I), 40 patients with alcoholic cirrhosis (group II), and 22 patients with a normal liver and symptoms of gastro-oesophageal reflux (control refluxers). Gastro-oesophageal reflux was observed in 10 of the cirrhotic patients. Marked reflux episodes lasted longer in cirrhotic refluxers than in control refluxers (P less than 0.05). The frequency of ascites, bleeding from ruptured oesophageal varices, peripheral neuropathy and hepatic encephalopathy were not significantly different according to presence or absence of reflux. Plasma concentrations of gastrin, somatostatin, motilin and vasoactive intestinal peptide (VIP) were measured in groups I and II. Fasting plasma motilin levels, and the release of motilin and of VIP after the meal were higher in group II than in group I. Basal levels and post-prandial profiles of the four peptides tested did not differ between cirrhotics with or without gastro-oesophageal reflux. We conclude that in patients with alcoholic cirrhosis: gastro-oesophageal reflux is frequent (25%) and characterized by prolonged reflux episodes; reflux is not correlated with the degree of liver failure and plays no significant role in the rupture of oesophageal varices; and raised plasma motilin and VIP levels cannot account for the high incidence of reflux in cirrhotics.
对27名健康对照者（I组）、40名酒精性肝硬化患者（II组）以及22名肝脏正常但有胃食管反流症状的患者（对照反流者）在进食试验餐3小时后记录食管pH值。在10名肝硬化患者中观察到胃食管反流。肝硬化反流者中明显反流发作持续时间比对照反流者更长（P<0.05）。根据有无反流情况，腹水、食管静脉曲张破裂出血、周围神经病变和肝性脑病的发生率无显著差异。测定了I组和II组胃泌素、生长抑素、胃动素和血管活性肠肽（VIP）的血浆浓度。II组空腹血浆胃动素水平以及进食后胃动素和VIP的释放高于I组。所检测的四种肽的基础水平和餐后曲线在有或无胃食管反流的肝硬化患者之间无差异。我们得出结论，酒精性肝硬化患者：胃食管反流很常见（25%），且以反流发作时间延长为特征；反流与肝功能衰竭程度无关，在食管静脉曲张破裂中不起重要作用；血浆胃动素和VIP水平升高不能解释肝硬化患者反流的高发生率。
