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胃食管反流病中非酸反流情况及其与烧心的关系分析(1)
http://www.100md.com 2011年11月25日 陈海波 李艳军
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     [摘要] 目的:探讨胃食管反流病中酸反流、非酸反流的情况及其与烧心的关系。方法:选择收治的临床诊断为反流性食管病患者92例,根据消化内镜检查结果及24 h pH监测指标分为糜烂性食管炎(A组,40例)和非糜烂性反流病(B组,52例),比较两组联合阻抗-pH监测指标。结果:两组阻抗指标酸反流次数、酸反流时间百分比比较,差异有统计学意义(P<0.05)。两组非酸反流次数比率比较,差异有统计学意义(χ2=20.167,P<0.05);两组非酸反流烧心症状指数阳性率分别为22.5%(A组)、13.5%(B组)。结论:胃食管反流病中,无论糜烂性食管炎还是非糜烂性食管炎,非酸反流症状指数阳性均占相当的比例,提示非酸反流也是引起烧心的一个重要因素。

    [关键词] 烧心;酸返流;非酸反流;胃食管反流病;pH监测

    [中图分类号] R571 [文献标识码] B [文章编号] 1673-7210(2011)11(c)-169-02

    Non-acid reflux and its relationship with heart burn in the gastroesophageal reflux disease

    CHEN Haibo1,LI Yanjun2

    1.The People's Hospital of Ankang City, Shaanxi Province, Ankang 725000, China; 2.Eyes Hospital of Tangshan City, Hebei Province, Tangshan 063000, China

    [Abstract] Objective: To investigate the acid reflux, non-acid reflux and its relationship with heart burn in gastroesophageal reflux disease. Methods: 92 patients with gastroesophageal reflux disease in gastroenterology department were divided into erosive esophagitis group (group A of 40 patients) and non-erosive reflux disease group (group B of 52 cases) in base of digestive endoscopy and 24 h pH monitoring indicators, combined impedance-pH monitoring indicators of two groups were compaired. Results: The differences of frequency and acid reflux time percentage between two groups was statistically significant (P<0.05). Frequency percentage of non-acid reflux in two groups was significant different (χ2=20.167,P<0.05); the percentage of heart burn symptom positive in two groups was 22.5%, 13.5% separately. Conclusion: In gastroesophageal reflux disease, whether erosive esophagitis or the non-erosive esophagitis, the non-acid reverse flow symptoms index accounted for a significant portion, it prompts that non-acid reverse flow is also an important factor of heartburn.

    [Key words] Heart burn; Acid reflux; Non-acid reflux; Gastroesophageal reflux disease; pH monitoring

    胃食管反流病(gastroesophageal reflux disease,GERD)是指胃内容物,包括从十二指肠流入胃的胆盐和胰酶等反流入食管,引起食管黏膜损伤及其一系列并发症。胃食管反流病的治疗主要是质子泵抑制剂、H2受体阻滞剂、保护黏膜、促进动力等治疗。但有少部分患者抗酸治疗效果不佳,有研究证实该类患者治疗失败与非酸反流有关[1-2]。本文笔者采用24 h多通道阻抗pH监测,探讨胃食管反流病中非酸反流的分布情况。现报道如下: ......

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