Mercer C D, Rue C, Hanelin L, Hill L D
Am J Surg. 1985 Jan;149(1):177-81. doi: 10.1016/s0002-9610(85)80029-5.
Esophageal transit time as measured by radionuclide scintigraphy using a swallowed technetium sulfur colloid bolus was measured in obese patients with gastroesophageal reflux, lean patients with reflux, and lean volunteers without reflux. The esophageal transit time was significantly prolonged in the obese group compared with both lean groups (p less than 0.001). Esophageal manometric measurement also confirmed that obese patients have an elevated gastroesophageal pressure gradient, presumably caused by increased intraabdominal pressure resulting from the mechanical burden of excess fat. The esophageal transit time is significantly related to the gastroesophageal pressure gradient. This finding, coupled with those in previous manometric investigations showing that esophageal muscle has a decreased maximum velocity with increasing afterload, explains in part why obese patients have delayed esophageal transit time. Therapy for reflux in obese patients should be aimed at improving esophageal transit.
采用吞咽锝硫胶体团注法通过放射性核素闪烁扫描术测量肥胖胃食管反流患者、消瘦反流患者以及无反流的消瘦志愿者的食管通过时间。与两个消瘦组相比，肥胖组的食管通过时间显著延长（p<0.001）。食管测压测量也证实肥胖患者的胃食管压力梯度升高，推测是由于过多脂肪的机械负担导致腹内压升高所致。食管通过时间与胃食管压力梯度显著相关。这一发现，再加上之前测压研究表明食管肌肉随着后负荷增加最大速度降低，部分解释了为什么肥胖患者食管通过时间延迟。肥胖患者反流的治疗应旨在改善食管通过。
