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据流行病学观察,吸烟常伴有症状性胃食管返流性疾病(GERD),吸烟使食管炎愈合发生障碍,而直接加重GERD。Stanciu等对25例伴返流性疾病的吸烟者,持续记录食管下端pH 15 h,发生返流226次,其中102次与吸一支烟有关。目前对GERD病理生理学的理解,提示该病的严重程度与食管对酸的接触程度有关,后者又取决于返流频度和食管对酸的清除时间,因此,吸烟可促使返流或延长食管对酸的清除时间,而加重返流性疾病。早期研究主要集中于食管下端括约肌(LES)压力,其结论是吸烟可短暂降低LES压。但最近对酸返流机理的理解,强调非吞咽性LES短暂松弛的重要性,而不是LES压的绝对值。Kjellen等研究11例
According to epidemiological observations, smoking is often accompanied by symptoms of gastroesophageal reflux disease (GERD), smoking esophagitis healed obstacles, and directly aggravate GERD. Stanciu and other 25 patients with reflux disease smokers continued to record the bottom of the esophagus pH 15 h, 226 cases of reflux occurred, of which 102 times and smoking a cigarette related. The current understanding of the pathophysiology of GERD suggests that the severity of the disease is related to the degree of esophageal acid exposure, which in turn depends on the frequency of reflux and the time of esophageal acid clearance, so smoking can cause reflux or extend the esophagus Acid clearing time, and aggravating reflux disease. Earlier studies focused on the lower esophageal sphincter (LES) pressure, concluding that cigarette smoking reduced the LES pressure temporarily. However, the recent understanding of the mechanism of acid reflux emphasizes the importance of transient relaxation of non-swallowing LES rather than the absolute value of LES pressure. Kjellen and other studies in 11 cases