十二指肠球部溃疡伴胃食管反流患者食管动力及胃内pH值监测

目的：探讨胃食管反流(GER)常见于十二指肠球部溃疡的原因。方法：选择近5年我院接受胃食管动力检查并行胃镜检查明确诊断为十二指肠球部溃疡的患者46例。食管pH监测胃食管酸反流阳性或胃镜检查存在反流性食管炎(RE)者为反流组，食管pH值监测胃食管酸反流阴性者为非反流组。比较两组食管下括约肌(IES)、食管体部及食管上括约肌(UES)等功能差别，同时对两组胃pH值监测进行比较。结果：十二指肠球部溃疡患者为GER／RE的高发人群，反流组与非反流组LES长度、功能压、食管体部清除功能、UES静息压比较差异无显著性。反流组每日不同时限胃酸分泌高于非反流组。结论：十二指肠球部溃疡易合并GER／RE与胃酸增高有关，与食管动力变化关系不大。

Study on the pathogeny of gastroesophageal reflux with duodenal ulcer

Objective To explore the pathogeny of gastroesophageal reflux(GER)in duodenal ulcer(DU).Methods Esophageal motility test and esophageal/gastric pH monitor for 24 hours were performed in 46 DU cases.Patients with GER diagnosed by esophageal pH monitor or reflux esophagitis(RE)by endoscopy were regarded as the reflux group,others as the non-reflux group.SPSS were used for statistic analysis.Results There are no differences of the LES pressure,clearance function of esophageal body and UES pressure between reflux group and non-reflux group.The gastric pH in supine and upright position as well as other periods of time in reflux group was lower than that in non-reflux group during 24 hours gastric pH monitor(P<0.05).Conclusion Higher gastric acid secretion instead of the disorders of esophageal motility is closely related to the GER/RE accompanied with DU patients.