MECHANISMS OF GASTRO-ESOPHAGEAL REFLUX IN PATIENTS WITH REFLUX ESOPHAGITIS
MECHANISMS OF GASTRO-ESOPHAGEAL REFLUX IN PATIENTS WITH REFLUX ESOPHAGITIS
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DOI：
10.1056/nejm198212163072503
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发表时间：
1982-01-01
影响因子：
158.5
通讯作者：
EGIDE, MS
中科院分区：
文献类型：
--
作者：
DODDS, WJ;DENT, J;EGIDE, MS
研究了10例反流性食管炎患者胃食管反流的发生机制，并将结果与10例对照进行了比较。患者有更多的反流发作（35 .+-）。在12小时内增加15个，而在12小时内增加9个。8)和较低的食管下括约肌压力(13 .+-。8毫米汞柱与29毫米汞柱相比。对照组9例)（P < 0.001）。反流通过3种不同的机制发生：短暂的食管下括约肌完全放松，短暂的腹内压力增加或自发的自由反流，与低静息的食管下括约肌压力相关。在对照组中，94%的反流发作是由短暂的括约肌松弛引起的。在患者中，65%的反流发作伴有短暂的括约肌松弛，17%伴有短暂的腹内压升高，18%为自发的自由反流。个别患者的主要反流机制各不相同：一些患者的静息括约肌压力正常，反流主要发生在短暂的括约肌松弛期间，而另一些患者的静息括约肌压力低，则是自发的自由反流或腹内压升高时发生的反流。
The mechanisms of gastroesophageal reflux in 10 patients with reflux esophagitis were evaluated and the results were compared with findings from 10 controls. The patients had more episodes of reflux (35 .+-. 15 in 12 h, as compared with 9 .+-. 8 in the controls) and a lower pressure of the lower esophageal sphincter (13 .+-. 8 mmHg as compared with 29 .+-. 9 in the controls) (P < 0.001). Reflux occurred by 3 different mechanisms: transient complete relaxation of the lower esophageal sphincter, a transient increase in intraabdominal pressure or spontaneous free reflux associated with a low resting pressure of the lower esophageal sphincter. In controls 94% of reflux episodes were caused by transient sphincter relaxation. In the patients, 65% of episodes of reflux accompanied transient sphincter relaxation, 17% accompanied a transient increase in intraabdominal pressure and 18% occurred as spontaneous free reflux. The predominant reflux mechanism in individual patients varied: some had normal resting sphincter pressure and reflux that occurred primarily during transient sphincter relaxation, whereas others with low resting sphincter pressures had spontaneous free reflux or reflux that occurred during an increase in intraabdominal pressure.