Ferguson M K, Ryan J W, Little A G, Skinner D B
Ann Surg. 1985 Jun;201(6):728-35. doi: 10.1097/00000658-198506000-00009.
Clearance of refluxed acid from the distal esophagus is due to bolus emptying and salivary neutralization of acid. We compared results of 24-hour pH monitoring with acid clearance tests (ACT) and radioisotope swallows (RIS) in 26 symptomatic patients to determine which of the components of acid clearance is better correlated with gastroesophageal acid reflux (GER). Seven of eight patients with GER had delayed esophageal emptying on RIS. Abnormal salivary clearance of acid was present in nine of 18 patients without GER, accounting for a high false-positive rate of ACT. Delayed esophageal bolus emptying, not deficient acid neutralization by saliva, is the predominant component of abnormal acid clearance in patients with GER. RIS is superior to ACT as part of the evaluation of reflux symptoms, and may prove to be a valuable screening test for this condition.
远端食管中反流酸的清除是由于食团排空以及唾液对酸的中和作用。我们对26例有症状患者的24小时pH监测结果与酸清除试验（ACT）及放射性核素吞咽试验（RIS）结果进行了比较，以确定酸清除的哪些成分与胃食管酸反流（GER）相关性更好。8例GER患者中有7例在RIS检查中存在食管排空延迟。18例无GER患者中有9例存在唾液酸清除异常，这导致ACT出现较高的假阳性率。食管食团排空延迟而非唾液对酸的中和不足，是GER患者异常酸清除的主要成分。作为反流症状评估的一部分，RIS优于ACT，可能会被证明是针对这种情况的一项有价值的筛查试验。
