Increased esophageal sensitivity to acid and saline in patients with nonerosive gastro-esophageal reflux disease
Increased esophageal sensitivity to acid and saline in patients with nonerosive gastro-esophageal reflux disease
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DOI：
10.1097/01.mcg.0000225673.76475.9d
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发表时间：
2006-11-01
影响因子：
2.9
通讯作者：
Sato, Nobuhiro
中科院分区：
文献类型：
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作者：
Nagahara, Akihito;Miwa, Hiroto;Sato, Nobuhiro
目标：探讨非糜烂性反流病（NERD）的特点。背景：NERD不被认为是糜烂性胃食管反流病（eGERD）的一种较轻形式。虽然NERD在我国的发病率很高，但有关NERD的研究却很少。研究：我们进行了上消化道内镜检查以确诊GERD。对7名对照受试者、14名NERD和11名eGERD患者进行了改良酸灌注试验和盐水灌注试验。对酸和盐水的刺激反应功能通过典型症状感知的持续时间（分钟）、总感觉强度等级（0到10）和灌注感觉评分（SS）来量化，灌注感觉评分被定义为分钟和感觉强度等级的乘积。生理盐水的SS平均值在对照受试者中为0，在NERD患者中为12.0，在eGERD患者中为1.5（P < 0.01对照vs. NERD，P < 0.01 NERD vs. eGERD）。在对照组受试者中，酸的平均SS为0.9，NERD患者为52.5。eGERD组为23.0（P < 0.01），对照组与NERD组、对照组与eGERD组、NERD组与eGERD组均为P < 0.05）。NERD组中酸和盐水灌注SS之间存在统计学显著相关性，相关系数值为r = 0.57（P < 0.05）。结论：eGERD和NERD，尤其是NERD，不仅对酸而且对盐水灌注表现出食管过敏，表明对酸和其他因素的痛觉过敏（例如，心理和/或自主神经紊乱）可能在NERD的症状产生中起一定作用。
Goals: To investigate the features of nonerosive reflux disease (NERD).Background: NERD is not considered as a milder form of erosive gastro-esophageal reflux disease (eGERD). Although the prevalence of NERD was reported to be high in our country, there have been very few studies about NERD.Study: We performed upper gastrointestinal endoscopy to confirm the diagnosis of GERD. The modified acid perfusion test and saline perfusion test were performed in 7 control subjects, 14 NERD, and 11 eGERD patients. The stimulus-response function to acid and saline was quantified by the duration of typical symptom perception (minutes), total sensory intensity rating (0 to 10), and the perfusion sensory score (SS), which was defined as the product of minutes and the sensory intensity rating.Results: The mean value of SS by saline was 0 in control subjects, 12.0 in NERD patients, and 1.5 in eGERD patients (P < 0.01 control vs. NERD, P < 0.01 NERD vs. eGERD). The mean SS with acid was 0.9 in control subjects, 52.5 in NERD patients. and 23.0 in eGERD patients (P < 0.01 control vs. NERD, control vs. eGERD, P < 0.05 NERD vs. eGERD). A statistically significant association was shown between the acid and saline perfusion SSs with a correlation coefficient value of r = 0.57 in the NERD group (P < 0.05).Conclusions: Both eGERD and NERD, but especially NERD, exhibited esophageal hypersensitivity not only to acid but also saline perfusion, suggesting that hyperalgesia to acid and other factors (eg, psychologic and/or autonomic nerve disturbance) may play some roles in symptom generation in NERD.