Shoenut J P, Wieler J A, Micflikier A B
St Boniface General Hospital, Department of Medicine, Winnipeg, Manitoba, Canada.
Aliment Pharmacol Ther. 1993 Oct;7(5):509-13. doi: 10.1111/j.1365-2036.1993.tb00126.x.
Ambulatory 24-hour oesophageal pH studies were obtained from 11 patients with scleroderma who expressed either dysphagia (n = 6) or heartburn (n = 5) as their predominant oesophageal symptom. No significant differences were found in the extent of pattern of reflux between these two groups. The pH data of both scleroderma groups were combined and compared to an age- and sex-matched group of control subjects (n = 11). The reflux demonstrated by scleroderma patients was significantly greater than the control group in every category (P < 0.01). The percentage of time the pH was < 4.0 was not significantly different (P > 0.05) upright (29.9 +/- 19.8%) vs. supine (44.2 +/- 28.5%) in patients with scleroderma. Eight scleroderma patients underwent repeat pH studies while taking low-dose omeprazole (20 mg daily) and reflux was reduced significantly (P < 0.01) in all patients. The authors believe that 24-hour ambulatory oesophageal pH-monitoring should be routinely conducted in scleroderma patients to provide quantitative reflux data, even when heartburn is not expressed as a symptom. Omeprazole, 20 mg daily, provides adequate protection from the H+ component of the refluxate.
对11例硬皮病患者进行了24小时动态食管pH监测，这些患者以吞咽困难（n = 6）或烧心（n = 5）作为主要食管症状。两组之间反流模式的程度未发现显著差异。将两个硬皮病组的pH数据合并，并与年龄和性别匹配的对照组（n = 11）进行比较。硬皮病患者表现出的反流在各个类别中均显著高于对照组（P < 0.01）。硬皮病患者直立位（29.9 +/- 19.8%）与仰卧位（44.2 +/- 28.5%）时pH < 4.0的时间百分比无显著差异（P > 0.05）。8例硬皮病患者在服用低剂量奥美拉唑（每日20 mg）时进行了重复pH研究，所有患者的反流均显著减少（P < 0.01）。作者认为，即使烧心未表现为症状，也应常规对硬皮病患者进行24小时动态食管pH监测，以提供定量反流数据。每日20 mg的奥美拉唑可对反流物中的H+成分提供充分保护。
