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目的研究胃食管反流病的综合致病因素及个体化差异。方法使用专用软件控制的高分辨多通道灌注测压系统（ＰＣｐｏｌｙｇｒａｆＨＲ瑞典产）测定了正常人１８例及胃食管反流病患者２２例的食管下括约肌压力、胃内压、食管体动力参数以及２４小时食管ｐＨ监测各项参数。结果患者组胃内压明显高于对照组（１６４±１．１９）ｋＰａ对（１．０３±１．０２）ｋＰａ，Ｐ＜００５；患者组屏障压明显低于对照组（－０．３６±１．５）ｋＰａ对（０７４±１１２）ｋＰａ，Ｐ＜００５；食管中、远段蠕动压力在湿咽时低于对照组（６１０±２．１１）ｋＰａ对（１０．３３±７．７２）ｋＰａ、（７．５３±３．６２）ｋＰａ对（１１．４１±４．３３）ｋＰａ，Ｐ＜００５；酸清除时间患者组较对照组明显延长（１．５１±１．４７）ｍｉｎ对（０．５９±０．７２）ｍｉｎ，Ｐ＜００５；ｐＨ＜４所占百分比患者组明显高于对照组（２１２７±１８３２）％对（１４３±１２５）％，Ｐ＜００５。结论胃食管反流病的发病机制为多因素综合作用，包括ＬＥＳ功能障碍，胃内压、屏障压异常，食管体蠕动异常及酸清除时间延长、酸反流持续时间延长，在综合致病因素中存在个体化差异，为临床制定治疗?
Objective To study the integrated risk factors and individual differences of gastroesophageal reflux disease. Methods High-resolution multi-channel perfusion pressure-measuring system (PCpolygrafHR Sweden) controlled by special software was used to measure the lower esophageal sphincter pressure, intragastric pressure and esophageal motility parameters in 18 normal subjects and 24 patients with gastroesophageal reflux disease Hour esophageal pH monitoring of various parameters. Results The gastric pressure in the patients was significantly higher than that in the control group (1.64 ± 1.19 kPa vs. 1.03 ± 1.02 kPa, P <005). The barrier pressure in the patients was significantly lower than that in the control group 0.36 ± 1.5) kPa vs (074 ± 112) kPa, P <005; the peristalsis pressure in the middle and distal esophagus was lower than that in the control group (610 ± 2.11 ) KPa vs (10.33 ± 7.72) kPa, (7.53 ± 3.62) kPa vs (11.41 ± 4.33) kPa, P <005; (1.51 ± 1.47) min vs (0.59 ± 0.72) min, P <005; the percentage of patients with pH <4 was significantly higher than that of the control group (2127 ± 18min 32)% vs (1.43 ± 125)%, P <005. Conclusions The pathogenesis of gastroesophageal reflux disease is a multifactorial combination of factors including LES dysfunction, gastric pressure, abnormal barrier pressure, abnormal peristalsis of the esophageal mucosa, prolonged acid clearance and prolonged acid reflux. After the comprehensive pathogenic factors There are individual differences in the development of clinical treatment?