医学研究与教育 ›› 2014, Vol. 31 ›› Issue (4): 71-74.DOI: 10.3969/j.issn.1674-490X.2014.04.017

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胃食管反流病发病及症状感知机制

张珂1,刘俊峰2,向莎莎1,康蒙1,戴悦1   

  1. 1.河北大学附属医院肿瘤科,河北 保定,071000
    2.河北医科大学第四医院胸外科,河北 石家庄,050011
  • 收稿日期:2016-09-29 修回日期:2016-09-29 出版日期:2014-08-25 发布日期:2014-08-25

Mechanism of gastroesophageal relfux disease pathogenesis and its symptom perception

ZHANG Ke1,LIU Junfeng2,XIANG Shasha1,KANG Meng1,DAI Yue1   

  • Received:2016-09-29 Revised:2016-09-29 Online:2014-08-25 Published:2014-08-25

摘要: 胃食管反流病(GERD)的症状和并发症可能是由多种因素的机制产生的,其中包括了胃酸和胃蛋白酶等重要的致病因素。食管黏膜与反流的食物长期接触可能是由一个有缺陷的抗反流屏障和腔隙清除机制所导致的,也可能是食管上皮肉眼可观察到损伤产生的。对酸敏感的神经末梢受体可能在食管疼痛与食管感觉过敏的发生过程中发挥着作用。同时,特定细胞因子和趋化因子的分布似乎决定了GERD的不同表型。其部分解释了一部分患者的食管炎发生机制。尽管这些研究结果显示在GERD发病机制中有额外的炎症介质和神经递质产生,但食管过敏与食管炎症之间的关系仍然不明确。此外,胃食管反流病患者绝大多数(70%)不发展食为管糜烂,被称为非糜烂性反流病。探讨GERD发病机制中炎症的激活途径,以更好地了解的侵蚀性和非糜烂性反流病患者,并提供新的治疗方法。

关键词: 胃食管反流病, 感知, 机制, 症状, 发病

Abstract: The pathogenesis of GERD symptoms may have a multifactorial mechanism, in which noxious factors, including acid-pepsin and acid, are involved. The interaction of relfuxed content and esophageal mucosa probably caused by a defective luminal clearance and mucosa barrier mechanisms, would be responsible for visual detectable lesion of esophageal mucosa. The researches of animal models with long time contact of acid content demonstrated that receptors on nerve endings may be involved in esophageal sensitivity and nociception. At the meantime, speciifc chemokine and cytokine may explain the different esophageal subtypes of GERD, partly illuminating the genesis of esophagitis in a subtype. Researches indicate that there are additional neurotransmitters and inlfammatory mediators in GERD patients, the relationship of the esophageal inlfammation and hypersensitivity is still not clear. Moreover, over 70%of GERD patients don’t to be erosive, a subset called non-erosive relfux disease. This summary aims to elucidate the pathogenesis of inlfammatory in GERD to differentiate erosive and non-erosive relfux disease and provide new therapeutic approaches.

Key words: gastroesophageal relfux disease, perception, mechanism, symptom, pathogenesis

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