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目的 探讨自发性夜间胃碱化的形成是否与十二指肠胃反流 (DGR)及迷走神经功能有关。方法 2 0例功能性消化不良 (FD)患者采用胃内 pH和胆红素同步监测法 ,比较夜间自发性碱化与胆汁反流的关系 ;另外 2 0例无心血管疾病的FD患者采用胃内 pH和心电Holter同步监测 ,进行心率变异性 (HRV)时域分析 ,以SDNN、rMSSD、PNN5 0为指标 ,观察夜间自发性碱化与迷走神经功能的关系。结果 2 0例FD患者中出现夜间自发性碱化者 1 2例 ,其中 8例 (占66.7% )同时有胆红素吸光值升高 ;2 0例无心血管疾病的FD患者中 1 3例有夜间自发性碱化 ,7例无自发性碱化 ,二者比较SDNN、rMSSD均在正常范围 ,差异无显著性 (P >0 .0 5 ) ;2 4h胃 pH与PNN5 0对照观察表明 ,夜间时段与白天相比PNN5 0明显升高 ,有自发性碱波组与无自发性碱化组二者相比 ,PNN5 0无显著差别。结论 自发性夜间胃碱化的形成与DGR有关 ,并不是迷走神经张力降低导致胃酸分泌减少所致。
Objective To investigate whether spontaneous nocturnal gastric alkalosis is associated with duodenal gastric reflux (DGR) and vagal function. Methods Twenty patients with functional dyspepsia (FD) underwent synchronous monitoring of gastric pH and bilirubin to compare the relationship between spontaneous alkalization at night and bile reflux. Another 20 patients with FD without cardiovascular disease were treated with intragastric The heart rate (HRV) time-domain analysis was performed with the simultaneous monitoring of pH and Holter Holter. The relationship between spontaneous alkalization and vagal function was observed with SDNN, rMSSD and PNN5 0 as indexes. Results Twenty cases of spontaneous basal at night were found in 20 patients with FD, of which 8 (66.7%) had elevated bilirubin absorbance at the same time. Twenty cases of FD patients without cardiovascular disease had Spontaneous alkalization at night, 7 cases without spontaneous alkalization, the two compared SDNN, rMSSD were in the normal range, the difference was not significant (P> 0.05); 24 h gastric pH and PNN5 0 control showed that night Compared with daytime PNN5 0 significantly increased, spontaneous alkali wave group and no spontaneous alkalization group compared to both PNN5 0 no significant difference. Conclusions The formation of spontaneous nocturnal gastric alkalosis is related to DGR, which is not caused by the decrease of gastric acid secretion caused by the decrease of vagal tone.