Bost R, Hostein J, Gignoux C, Busquet G, Lachet B, Fournet J
Gastroenterol Clin Biol. 1986 Apr;10(4):322-7.
Several studies concerning the relationships between gastroesophageal reflux (GOR), gastric emptying and esophageal motility are available. So far, results have been contradictory. The purpose of this work was to study gastric emptying in patients with GOR; to search for simultaneous esophageal motility disorders and to specify their type and frequency; to establish a potential relationship between motor disorders of the esophagus and the stomach in these patients. Thirty-two consecutive patients were selected according to clinical criteria, i.e. presence of at least two of the three characteristic symptoms of GOR, and the data of a three-hour post-prandial pH-metry. Gastric stasis related clinical manifestations (nausea, post-prandial vomiting, sensation of abdominal distension or of post-prandial epigastric fullness) were also searched for in all patients. A gastroscopy allowed to score esophagitis in each case. All patients, including adult controls underwent an esophageal manometry as well as a radionuclide determination of gastric emptying, after isotopic labelling of the solid (S) and liquid (L) phases of a test meal. The results showed that there was no significant modification of gastric emptying of the S and L phases of the meal in the group of patients with GOR whatever the intensity of the reflux, judged on the pH-metry results and the endoscopic data. Thus the average time of gastric half-emptying of S and L was respectively 115 and 52 min for the patients vs 111 and 51 min for the control group. As well, no correlation was found between the gastric emptying parameters and the presence or absence of clinical signs of gastric stasis or the amplitude of esophageal contraction waves. On an individual basis, two patients showed a significant decrease in gastric emptying of either the S or L phases without any attendant modification in the kinetics of the other. These results suggest that, in the adult, gastric emptying cannot be considered to be a determining factor of GOR and there are no diffuse motility disorders of the upper digestive tract during this illness.
已有多项关于胃食管反流（GOR）、胃排空与食管动力之间关系的研究。到目前为止，结果相互矛盾。本研究的目的是：研究GOR患者的胃排空情况；寻找同时存在的食管动力障碍并明确其类型和发生率；确定这些患者食管和胃的动力障碍之间的潜在关系。根据临床标准，即存在GOR三个特征性症状中的至少两个，以及餐后三小时pH值测定数据，连续选取了32例患者。还在所有患者中寻找与胃潴留相关的临床表现（恶心、餐后呕吐、腹胀感或餐后上腹部饱胀感）。通过胃镜检查对每例患者的食管炎进行评分。所有患者，包括成年对照组，在对试餐的固体（S）和液体（L）相进行同位素标记后，均接受了食管测压以及放射性核素胃排空测定。结果显示，无论根据pH值测定结果和内镜数据判断反流强度如何，GOR患者组餐食S和L相的胃排空均无显著改变。因此，患者组S和L相胃半排空的平均时间分别为115分钟和52分钟，而对照组分别为111分钟和51分钟。同样，未发现胃排空参数与胃潴留临床体征的有无或食管收缩波幅度之间存在相关性。就个体而言，两名患者的S相或L相胃排空显著降低，而另一相的动力学无任何相应改变。这些结果表明，在成年人中，胃排空不能被视为GOR的决定因素，并且在这种疾病期间上消化道不存在弥漫性动力障碍。
