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目的探讨贲门松弛与胃食管反流病(GERD)的关系,并寻找与GERD患者临床表现相关的主要胃液成分,为GERD的临床诊疗提供依据。方法本实验采用RDQ量表积分≥12分或内镜下可见反流性食管炎表现(内镜下可见的食管黏膜发红、充血、糜烂破损)作为GERD诊断标准,收集内镜下通过贲门镜身比诊断贲门松弛的患者197例,将病例分为GERD组和非GERD组,探讨贲门松弛程度和GERD发病率之间是否存在相关性。收集贲门松弛患者的胃液,研究GERD组和非GERD组患者胃液成分的差异,所得数据采用SPSS 17.0软件统计分析。结果随着贲门松弛程度的增加,GERD发生率增加,差异具有统计学意义(P<0.05)。贲门松弛的患者中,GERD患者较非GERD患者而言,前者胃液中胃酸及胆汁酸含量显著高于后者(P<0.05),而胃蛋白酶及淀粉酶含量无统计学差异(P>0.05)。结论贲门松弛与GERD密切相关,贲门松弛程度越重,GERD发生率越高。贲门松弛患者的胃食管反流发生与胃液中胃酸及胆汁酸密切相关,临床可尝试从改善贲门松弛程度、抑酸促动力方面着手改善贲门松弛患者的胃食管反流。
Objective To investigate the relationship between cardia relaxation and gastroesophageal reflux disease (GERD) and to find out the main components of gastric juice related to the clinical manifestations of GERD, so as to provide evidence for the clinical diagnosis and treatment of GERD. Methods The experiment using RDQ scale integral ≥ 12 points or endoscopic retrograde esophagitis (endoscopic esophageal mucosal redness, congestion, erosion damage) as a diagnostic criteria for GERD, collected by endoscopy through the cardia Comparing 197 patients diagnosed cardia relaxation, the patients were divided into GERD group and non-GERD group to explore whether there is a correlation between the degree of cardia relaxation and the incidence of GERD. Gastric fluid in patients with cardiac cardia was collected to study the difference of gastric contents in patients with GERD and non-GERD. The data were analyzed by SPSS 17.0 software. Results With the increase of cardia relaxation, the incidence of GERD increased, the difference was statistically significant (P <0.05). Among the patients with cardia relaxation, the content of gastric acid and bile acid in gastric juice of patients with GERD was significantly higher than that of non-GERD patients (P <0.05), while there was no significant difference in pepsin and amylase (P> 0.05) . Conclusions Cardia relaxation is closely related to GERD. The more cardia relaxation, the higher the incidence of GERD. Gallbladder patients with gastroesophageal reflux gastritis and gastric acid and bile acid are closely related to the clinical trial may try to improve the degree of cardia relaxation, acid suppression motivation to improve cardia gastroesophageal reflux patients.