脂肪对胃食管酸反流的影响和体重指数与胃食管酸反流的关系

目的评估饮食脂肪对胃食管酸反流的影响和体重指数（BMI）与胃食管酸反流的关系。方法选择23例健康志愿者和22例胃食管反流病（GERD）患者，记录受试者基本情况，先行食管测压，先后两次服用低脂餐和高脂餐，每次监测餐后6h食管pH值。结果健康志愿者和GERD患者在两种热量相等的低脂餐和高脂餐后，pH〈4总反流时间百分率，反流时间〉5min的反流次数及总反流次数的比较，均无显著性差异（P〉0．05）；BMI≥25受试者的pH〈4总反流时间百分率和反流时间〉5min的反流次数高于BMI〈25受试者，两者有显著性差异（P〈0．01）。结论在同热量含量下，食物中脂肪含量对健康志愿者和GERD患者餐后6h酸反流无影响；而肥胖可能会增加胃食管酸反流。

Effect of fat on gastroesophageal reflux and relationship between body mass index and gastroesophageal reflux

Objective To assess the effect of fat on gastroesophageal reflux and relationship between body mass index （BMI） and gastroesophageal reflux. Methods Twenty-three healthy volunteers and twenty-two patients with gastroesophageal reflux disease were studied. All medical information for each individual and the lower esophageal sphincter pressure were measured. 6-hour esophageal pH were monitored after the lower and the high fat meals eaten on separate days in a randomized order. Results No difference was observed between healthy volunteers and GERD patients for the mean percentage of time at pH 〈 4, number of reflux episodes over 5 minutes and the number of reflux episodes after equicaloric low and high fat meals （P 〉 0. 05）. The mean pereentage of time at pH 〈 4 and the umber of reflux episodes over 5 minute in group which BMI ≥ 25 were significantly higher than those BMI 〈 25 （P 〈 0.01 ）. Conclusion Increasing fat intake does not affect gastroesophageal acid reflux for at least six hours postprandial period either in healthy volunteers or in GERD patients with the same energe intake. Obesity possibly increases the risk for gastroesophageal acid reflux.