de Caestecker J S, Blackwell J N, Pryde A, Heading R C
Gut. 1987 May;28(5):519-26. doi: 10.1136/gut.28.5.519.
Fifty two patients were studied to investigate the patterns of gastro-oesophageal reflux during ambulatory pH monitoring and the relationship of reflux to presence and severity of oesophagitis. Twenty nine had evidence of oesophagitis which was graded according to severity. Acid exposure (pH less than 4) was calculated in each case for the total study period, the recumbent and upright periods, and the three hour period after the evening meal. Exposure in the upright period correlated closet (r=0.92: p less than 0.001) with that during the total period. Recumbent exposure correlated with both upright and postprandial exposure (p less than 0.001). Acid exposure during all four periods correlated significantly with the severity of oesophagitis, but postprandial acid exposure correlated best and recumbent acid exposure least well. Although acid clearance in the total, recumbent and upright periods correlated with oesophagitis, postprandial clearance showed the closest relationship. Thus the magnitude of daytime reflux, especially postprandial reflux and acid clearance, is more closely related than nocturnal reflux to oesophagitis. The results do not support the contention that night time reflux is inherently more injurious than daytime reflux to the oesophageal mucosa.
对52例患者进行了研究，以调查动态pH监测期间胃食管反流的模式以及反流与食管炎的存在和严重程度之间的关系。29例有食管炎证据，并根据严重程度进行分级。计算了每例患者在整个研究期间、卧位和立位期间以及晚餐后三小时期间的酸暴露（pH值小于4）情况。立位期间的暴露与整个期间的暴露相关性最强（r = 0.92，p小于0.001）。卧位暴露与立位和餐后暴露均相关（p小于0.001）。所有四个时间段的酸暴露均与食管炎的严重程度显著相关，但餐后酸暴露相关性最佳，卧位酸暴露相关性最差。尽管整个、卧位和立位期间的酸清除与食管炎相关，但餐后清除显示出最密切的关系。因此，与夜间反流相比，白天反流的程度，尤其是餐后反流和酸清除，与食管炎的关系更为密切。结果不支持夜间反流对食管黏膜本质上比白天反流更具伤害性的观点。
