Benini L, Sembenini C, Castellani G, Caliari S, Fioretta A, Vantini I
Department of Gastroenterology, Rehabilitation Hospital of Verona University in Valeggio SM, Italy.
Am J Gastroenterol. 1996 Jul;91(7):1351-4.
To clarify 1) whether gastric emptying of a mixed meal is delayed in patients with gastroesophageal reflux and 2) the relationship between dyspeptic symptoms and delayed gastric emptying in refluxers.
Gastric emptying of a solid meal was studied by ultrasound in 25 patients with pathological esophageal acid exposure. Gastric emptying was then assessed in relation to upper digestive endoscopy, esophageal manometry, 24-h pH monitoring and quantification of symptoms of reflux- and dysmotility-like dyspepsia.
Fifteen of 25 refluxers had esophagitis, and 15 were "dyspeptic". Refluxers exhibited a significant delay in gastric emptying compared with controls [307.6 (21.0) vs. 209 (10.4) min, p < 0.001). Patients with delayed emptying had low LES pressure [11.9 (2.1) vs. 18.6 (2.1) mm Hg, p < 0.05]. There was no correlation between delayed emptying and either pH monitoring or presence of esophagitis. There were no differences in any of the pH monitoring parameters between refluxers with and without coexisting dysmotility-like symptoms.
Gastric emptying of a solid meal is markedly delayed in patients with gastroesophageal reflux. However, no direct causal link was found between delayed emptying and reflux. Our data suggest the presence of a motility disorder in gastroesophageal reflux which is not confined to the esophagogastric junction.
1）明确胃食管反流患者混合餐的胃排空是否延迟；2）反流患者消化不良症状与胃排空延迟之间的关系。
通过超声研究25例食管酸暴露异常患者固体餐的胃排空情况。然后根据上消化道内镜检查、食管测压、24小时pH监测以及反流样和运动障碍样消化不良症状的量化评估胃排空情况。
25例反流患者中15例有食管炎，15例有“消化不良”症状。与对照组相比，反流患者的胃排空明显延迟[307.6（21.0）分钟对209（10.4）分钟，p<0.001]。胃排空延迟的患者下食管括约肌压力较低[11.9（2.1）mmHg对18.6（2.1）mmHg，p<0.05]。胃排空延迟与pH监测或食管炎的存在均无相关性。有和没有并存运动障碍样症状的反流患者在任何pH监测参数上均无差异。
胃食管反流患者固体餐的胃排空明显延迟。然而，未发现胃排空延迟与反流之间存在直接因果关系。我们的数据表明胃食管反流中存在运动障碍，且不限于食管胃交界处。
