摘要
目的探讨非糜烂性胃食管反流病不同于反流性食管炎的发病机制。方法选择1996～2004年北京大学人民医院因反酸、胃灼热感等反流症状确诊为胃食管反流病患者57例,按照内镜下食管黏膜有无破损分为非糜烂性胃食管反流病组和反流性食管炎组,比较两组的一般情况、反流症状、是否合并H.pylori(Hp)感染,以及食管动力测定和食管胃24hpH监测结果。结果两组患者年龄、性别、烟酒嗜好等一般情况及合并Hp感染情况比较差异无显著性。非糜烂性胃食管反流病组不典型反流症状(胸骨后痛)的发生率明显高于反流性食管炎组。两组患者都存在病理性酸反流,但两组患者之间酸和(或)碱反流比较无差异。非糜烂性胃食管反流病患者的食管体部各段蠕动波峰值明显高于反流性食管炎患者。非糜烂性胃食管反流病患者卧位胃酸分泌高于反流性食管炎患者。结论非糜烂性胃食管反流病的不典型反流症状发生率更高。在两组发病机制异同上,反流的强弱并非主要因素,重要的是食管防御机制的差别。
Objective To study the different pathogenesis between non-erosive gastroesophageal reflux disease(NERD) and reflux esophagitis(RE).Methods 57 patients with regurgitation or heartburn from 1996 to 2004 were assessed in this study.Patients with esophageal mucosal break by endoscopy were regarded as the RE group,others as the NERD group.The clinical feature and whether complicating with H.pylori infection in both groups were reviewed and all patients underwent esophageal manometry and 24 hours esophageal/gastric pH monitoring.Results No differences of age?sex?smoking?drinking and Hp infection were found between the two groups.The incidence of the atypical reflux symptom (chest pain) in the NERD group was higher than in the RE group.There was pathologic acid reflux in both groups,but the two groups did not differ at reflux degree.Esophageal body peristaltic amplitude of the NERD group was higher than that of the RE group.Average gastric pH of the NERD group in supine was lower compared with the RE group.Conclusion In the NERD patients,the incidence of the atypical reflux symptom is more prevalent.It is the esophageal acid clearance not the reflux degree that plays an important role in the different pathogenesis between NERD and RE.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2005年第6期525-527,共3页
Chinese Journal of Practical Internal Medicine
关键词
非糜烂性胃食管反流病
食管动力
食管胃pH监测
Non-erosive gastroesophageal reflux disease Esophageal manometry Esophageal/gastric pH monitoring
