Intra-oesophageal distribution and perception of acid reflux in patients with non-erosive gastro-oesophageal reflux disease
Intra-oesophageal distribution and perception of acid reflux in patients with non-erosive gastro-oesophageal reflux disease
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DOI：
10.1046/j.1365-2036.2003.01702.x
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发表时间：
2003-09-15
影响因子：
7.6
通讯作者：
Pallone, F
中科院分区：
文献类型：
--
作者：
Cicala, M;Emerenziani, S;Pallone, F
工作背景：大多数胃食管反流病患者不存在糜烂性食管炎，构成异质性组。非糜烂性胃食管反流病患者对抑酸治疗的反应低于糜烂性食管炎患者。目的：评估酸反流在胃食管反流病症状中的作用。方法：分析45例非糜烂性胃食管反流病患者和20例糜烂性食管炎患者反流事件的时空特征，并与反流感知相关。结果：与健康对照组相比，所有患者的食管内近端酸扩散均较高，这在非糜烂性胃食管反流病患者中尤为突出（> 50%的事件持续1-2分钟）。不考虑粘膜损伤，当酸到达近端传感器时，反流感知的风险非常高（比值比，7.6; 95%置信区间，4.6-12.5），在酸暴露时间正常的非糜烂性胃食管反流病患者中最高（比值比，11; 95%可信区间，5.2-22.3）。非糜烂性胃食管反流病患者的特点是近端酸反流的比例明显较高，对短-与食管炎患者相比，最高近端酸暴露和最高感知发生在pH值正常的非糜烂性胃食管反流病患者中。评估酸分布及其在食管体的感知可以更好地识别应受益于抑酸治疗的反流患者。
Background: The majority of patients with gastro-oesophageal reflux disease do not present with erosive oesophagitis and make up a heterogeneous group. Patients with non-erosive gastro-oesophageal reflux disease are less responsive than patients with oesophagitis to acid-suppressive therapy.Aim: To assess the role of acid reflux in gastro-oesophageal reflux disease symptoms.Methods: The spatio-temporal characteristics of reflux events were analysed and related to reflux perception in 45 patients with non-erosive gastro-oesophageal reflux disease and 20 patients with erosive oesophagitis.Results: Compared with healthy controls, all patients showed a higher intra-oesophageal proximal spread of acid, which was prominent in patients with non-erosive gastro-oesophageal reflux disease (> 50% of events lasting for 1-2 min). Irrespective of mucosal injury, the risk of reflux perception was very high when acid reached proximal sensors (odds ratio, 7.6; 95% confidence interval, 4.6-12.5), being maximal in patients with non-erosive gastro-oesophageal reflux disease with normal acid exposure time ( odds ratio, 11; 95% confidence interval, 5.2-22.3).Conclusions: Patients with non-erosive gastro-oesophageal reflux disease are characterized by a significantly higher proportion of proximal acid refluxes and a higher sensitivity to short-lasting refluxes when compared with patients with oesophagitis. The highest proximal acid exposure and highest perception occurred in patients with non-erosive gastro-oesophageal reflux disease presenting with a normal pH-metric profile. The assessment of acid distribution and its perception in the oesophageal body can better identify reflux patients who should benefit from acid-suppressive treatment.