Gastroenterology:腰腹部压迫加重胃食管反流

2017-04-01 zhangfan MedSci原创

腹压会增加餐后食管炎患者胃酸反流事件发生率,引起胃内压升高

中心性肥胖导致的胃食管反流可能与腹内压增高有关,研究人员近日研究了腰带增加腹压对反流病患者返流的影响。

研究招募了8名食管炎患者以及6名Barrett食管炎患者,患者平均年龄56岁,平均体重指数为26.8。研究开始的前7天和前24小时停用质子泵抑制剂和H2受体拮抗剂。研究评估上消化道症状的严重程度并测量患者的身高、体重、腰围和臀围。高分辨率pH值测量和压力测量在餐前20分钟和餐后90分钟进,压力测试使用的腰带为一个举重紧皮带和充气到恒定压力为50mmHg袖带。

结果表明,无腰带时,胃内压与腰围相关(r=0.682; P=0.008),胃内压力与最小和最大腰围的压力差为15mmHg;在空腹期间,腰带增加的胃内压中位数为6.9mmHg(P=0.002),餐后为9.0 mmHg(P=0.001)。餐后,有无腰带对胃食管反流事件的平均数为4 vs 2;短暂的食管下括约肌松弛后,带(不带)皮带对胃食管反流事件的平均数为3.5 vs 2;皮带对回流食管酸清除影响最大(无皮带平均清除时间为23s vs有皮带81.1s)。

研究表明,皮带会增加餐后食管炎患者胃酸反流事件发生率,引起胃内压升高。这种效应解释了肥胖程度和反流病发病概率成正相关的原因。

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    2017-05-12 zzc2211
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topicList=[TopicDto(id=83397, encryptionId=87828339e7a, topicName=胃食管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sat Apr 29 02:00:00 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071720, encodeId=b62320e1720e4, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Jan 15 00:00:00 CST 2018, time=2018-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190981, encodeId=97ec190981fb, content=所以中心性肥胖的人更要注意了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/1838A520E8D0EFD072AFB21C03833935/100, createdBy=3db12041149, createdName=医路无憾, createdTime=Thu Apr 27 07:35:31 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188229, encodeId=4147188229f9, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJicFGXtYqfjGiaibNdjOiaRgkexnXiciaDeXaLiaKicovcicDugdYwRPSnQj3FlfXBwVLB5ANB9PGFyB0kraQ/0, createdBy=35b01663265, createdName=1ddf3e1dm99(暂无匿称), createdTime=Mon Apr 17 12:00:38 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188024, 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  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/1838A520E8D0EFD072AFB21C03833935/100, createdBy=3db12041149, createdName=医路无憾, createdTime=Thu Apr 27 07:35:31 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188229, encodeId=4147188229f9, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJicFGXtYqfjGiaibNdjOiaRgkexnXiciaDeXaLiaKicovcicDugdYwRPSnQj3FlfXBwVLB5ANB9PGFyB0kraQ/0, createdBy=35b01663265, createdName=1ddf3e1dm99(暂无匿称), createdTime=Mon Apr 17 12:00:38 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188024, encodeId=9baa188024ac, content=看来以后不能拉紧皮带了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sun Apr 16 22:16:29 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187991, encodeId=98fe18e99177, content=中心性肥胖导致的胃食管反流可能与腹内压增高有关,, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Sun Apr 16 20:59:05 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187981, encodeId=ff1e18e9816e, content=学习下,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2041447, createdName=1881e9c2b1m, createdTime=Sun Apr 16 20:26:19 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2018-01-15 许安
  6. 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GetPortalCommentsPageByObjectIdResponse(id=187981, encodeId=ff1e18e9816e, content=学习下,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2041447, createdName=1881e9c2b1m, createdTime=Sun Apr 16 20:26:19 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-27 医路无憾

    所以中心性肥胖的人更要注意了

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/1838A520E8D0EFD072AFB21C03833935/100, createdBy=3db12041149, createdName=医路无憾, createdTime=Thu Apr 27 07:35:31 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188229, encodeId=4147188229f9, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJicFGXtYqfjGiaibNdjOiaRgkexnXiciaDeXaLiaKicovcicDugdYwRPSnQj3FlfXBwVLB5ANB9PGFyB0kraQ/0, createdBy=35b01663265, createdName=1ddf3e1dm99(暂无匿称), createdTime=Mon Apr 17 12:00:38 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188024, 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GetPortalCommentsPageByObjectIdResponse(id=187981, encodeId=ff1e18e9816e, content=学习下,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2041447, createdName=1881e9c2b1m, createdTime=Sun Apr 16 20:26:19 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-17 1ddf3e1dm99(暂无匿称)

    学习了,谢谢!

    0

  8. 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GetPortalCommentsPageByObjectIdResponse(id=187981, encodeId=ff1e18e9816e, content=学习下,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2041447, createdName=1881e9c2b1m, createdTime=Sun Apr 16 20:26:19 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-16 1ddf0692m34(暂无匿称)

    看来以后不能拉紧皮带了

    0

  9. 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GetPortalCommentsPageByObjectIdResponse(id=187981, encodeId=ff1e18e9816e, content=学习下,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2041447, createdName=1881e9c2b1m, createdTime=Sun Apr 16 20:26:19 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-16 knowheart

    中心性肥胖导致的胃食管反流可能与腹内压增高有关,

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=187981, encodeId=ff1e18e9816e, content=学习下,分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=101c2041447, createdName=1881e9c2b1m, createdTime=Sun Apr 16 20:26:19 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-16 1881e9c2b1m

    学习下,分享了

    0