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探讨自发性夜间胃碱化对十二指肠溃疡病的诊断价值。方法对３２例内镜诊断的活动性十二指肠球溃疡（ＤＵ），２１例胃食管反流性疾病〔有反酸、烧心和（或）胸痛等症状，内镜下为０～２级食管炎，食管下段动态２４ｈｐＨ检查积分＞１５．６〕，２３例功能性消化不良患者（有上腹部不适、胀满、上腹痛等症状，内镜下仅为红白相间等慢性炎症表现，食管下段动态２４ｈｐＨ检查积分＜１５．６）和１１例无上消化道症状的健康对照者的２４ｈ胃底（ＬＥＳ下５ｃｍ）和食管下段（ＬＥＳ上５ｃｍ）动态ｐＨ进行了研究。分析了夜间８ｈ（２３ｐｍ～７ａｍ）时间窗内自发性夜间胃碱化（ｓｐｏｎｔａｎｅｏｕｓｎｏｃｔｕｒ－ｎａｌｇａｓｔｒｉｃａｌｋａｌｉｎｉｚａｔｉｏｎ，ＳＮＡ）现象（ｐＨ＞４，时间大于５ｍｉｎ的ｐＨ升高）。结果①ＤＵ组夜间ＳＮＡ阳性率较对照组、ＦＤ和ＧＥＲＤ组明显低（Ｐ＜０．０５，Ｐ＜０．０１，Ｐ＜０．００１）。②对照组的ＳＮＡ阳性率与ＦＤ和ＧＥＲＤ组比较无显著性差别。③ＳＮＡ诊断ＤＵ的特异性和敏感性分别为８１．８％和８４．３％。结论本文结果说明自发性夜间胃碱化缺乏既是球溃疡发病的重要机制之一，亦可作为诊断球溃疡病的一个重要参考指标。
To explore the value of spontaneous nocturnal gastric alkalosis in the diagnosis of duodenal ulcer disease. Methods 32 cases of active duodenal ulcer (DU) diagnosed by endoscopy, 21 cases of gastroesophageal reflux disease (with acid reflux, heartburn and / or chest pain and other symptoms, 0 to 2 endoscopic Esophagitis, lower esophageal dynamic 24hpH checkpoints> 15.6〕, 23 cases of dysfunctional patients with functional dyspepsia (upper abdominal discomfort, fullness, abdominal pain and other symptoms, endoscopic only red and white and other chronic inflammatory manifestations, esophageal The dynamic pH of the bottom fundus (5 cm LES) and the lower esophageal segment (5 cm LES) of 11 healthy subjects with no upper gastrointestinal symptoms at the next 24 h dynamic 24hpH examination score <15.6 were studied. The spontaneous nocturnal gasomerization (SNA) phenomenon (pH> 4, pH greater than 5 min) during the 8 h (23 pm-7 am) time window was analyzed. Results ① The positive rate of SNA at night in DU group was significantly lower than that in control group, FD group and GERD group (P <0.05, P <0.01, P <0.001). ② The positive rate of SNA in control group showed no significant difference compared with FD and GERD groups. The specificity and sensitivity of SNA in diagnosing DU were 81.8% and 84.3% respectively. Conclusion The results of this study show that the lack of spontaneous nocturnal gastric alkalosis is not only one of the important pathogenesis of ulcer, but also as an important reference for the diagnosis of ulcer disease.