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目的：探讨胃食管反流（ＧＥＲ）的食管酸暴露与动力学改变特征。方法：采用２４ｈ食管ｐＨ值及压力联合动态监测，研究２７例ＧＥＲ患者（按食管炎０级、Ⅰ～Ⅱ级、Ⅲ～Ⅳ级分为３组）和１３例对照组患者的食管酸反流特征，及反流发生时食管体部动力改变，并以静态食管测压观察下食管括约肌（ＬＥＳ）静息压变化。结果：３个反流组总的、卧位和立位反流时间百分比均显著低于对照组（Ｐ＜０．０１）。Ⅲ～Ⅳ级食管炎组ＬＥＳ静息压显著低于其他各组（Ｐ＜０．０５），ＬＥＳ长度各组间无明显差异。３个反流组反流期食管蠕动频率均显著低于对照组（Ｐ＜０．０１）；伴食管炎的两组顺行性蠕动百分比较对照组明显降低（Ｐ＜０．０５），其他食管运动（同步、孤立、逆行）各组间无显著差异。Ⅲ～Ⅳ级食管炎组反流期食管蠕动波幅显著低于对照组，蠕动波间期各组间无显著差异。结论：ＧＥＲ患者的酸暴露程度与食管炎程度无显著的对应关系。ＬＥＳ静息压降低和反流发生后食管蠕动减少、频率减慢、幅度降低，可能在反流性食管炎发病中起重要作用
Objective: To investigate esophageal acid exposure and kinetic changes of gastroesophageal reflux disease (GER). Methods: Esophageal acid reflux was studied in 27 patients with GER (esophagitis grade 0, grade Ⅰ ~ Ⅱ, grade Ⅲ ~ Ⅳ, and group Ⅲ) and thirteen control groups using 24-hour esophageal pH and pressure monitoring. The changes of resting pressure of esophageal sphincter (LES) were observed with static esophageal manometry. Results: The total percentage of supine position and upright position in the three reflux groups were significantly lower than that in the control group (P <0.01). The resting pressure of LES in Ⅲ ~ Ⅳ esophagitis group was significantly lower than that in other groups (P <0.05). There was no significant difference in LES length between groups. The frequency of esophageal peristalsis in the three reflux groups was significantly lower than that in the control group (P <0.01). The percentages of progressive peristalsis in the two groups with esophagitis were significantly lower than those in the control group (P <0.05) Esophageal exercise (synchronous, isolated, retrograde) no significant difference between the groups. The level of esophageal peristalsis in stage Ⅲ ~ Ⅳ esophagitis group was significantly lower than that in control group, and there was no significant difference between the groups in peristaltic wave period. Conclusion: There was no significant correlation between acid exposure and esophagitis in GER patients. LES resting pressure and reflux esophageal peristalsis decreased, slowed down, decreased amplitude, may play an important role in the pathogenesis of reflux esophagitis