Robertson D, Aldersley M, Shepherd H, Smith C L
Medical Unit, Southampton General Hospital.
Gut. 1987 Nov;28(11):1484-8. doi: 10.1136/gut.28.11.1484.
Oesophageal manometry and 24 hour ambulatory pH recordings from the distal oesophagus were carried out in 25 patients with complications of oesophagitis (stricture, Barrett's oesophagus or oesophageal ulcer) and compared with 25 patients with uncomplicated oesophagitis. Acid reflux was more severe in the complicated group with 26.2% of time below pH 4 compared with 11.3% in uncomplicated patients (p less than 0.01). This difference was most marked at night, when complicated patients had long periods of acid reflux with 35.6% time less than pH 4 compared with 5.2% uncomplicated (p less than 0.001). The mean duration of nocturnal acid reflux was 15.4 minutes (2.1 minutes uncomplicated, p less than 0.001). Oesophageal motility was markedly abnormal in all groups, but with no demonstrable differences in lower oesophageal sphincter pressure or peristalsis between the groups. Patients with complications of oesophagitis have different patterns of acid reflux from uncomplicated patients, with prolonged nocturnal bathing of the oesophageal mucosa, which may be the cause of stricture formation, metaplasia, or ulceration.
对25例患有食管炎并发症（狭窄、巴雷特食管或食管溃疡）的患者进行了食管测压和远端食管24小时动态pH记录，并与25例无并发症的食管炎患者进行了比较。并发症组的酸反流更为严重，pH值低于4的时间占26.2%，而无并发症患者为11.3%（p<0.01）。这种差异在夜间最为明显，并发症患者有长时间的酸反流，pH值低于4的时间占35.6%，而无并发症患者为5.2%（p<0.001）。夜间酸反流的平均持续时间为15.4分钟（无并发症患者为2.1分钟，p<0.001）。所有组的食管动力均明显异常，但两组之间食管下括约肌压力或蠕动无明显差异。患有食管炎并发症的患者与无并发症的患者有不同的酸反流模式，夜间食管黏膜长时间处于酸性环境中，这可能是狭窄形成、化生或溃疡的原因。
