消化性溃疡患儿24小时胃pH值的动态研究

Ambulatory 24 hr gastric pH monitoring in children with peptic ulcer

目的了解消化性溃疡患儿胃ｐＨ值的动态变化。方法对２５例经胃镜确诊的消化性溃疡患儿作２４小时胃ｐＨ值测定，２５例健康儿作对照组。结果胃溃疡和十二指肠溃疡患儿各项胃ｐＨ值监测指标的差异无显著意义（Ｐ＞０．０５）；溃疡组胃ｐＨ平均值、平均中位数低于对照组（１．８±０．５比２．３±０．６，１．４±０．４比１．７±０．５，Ｐ分别＜０．０１、＜０．０５），而胃ｐＨ值＜２和＜３的时间百分比则高于对照组（７４．８±１３．７比６２．８±１５２，８５．９±８．６比７４．２±１３．１，Ｐ均＜０．０１）；溃疡组夜间胃ｐＨ平均值、平均中位数低于白天（１．６±０．５比２．１±０．５，１．３±０．４比１．６±０．５，Ｐ＜０．０１），而夜间胃ｐＨ值＜２和＜３的时间百分比则高于白天（８３．２±１４．０比６６．２±１９．９，９２．１±８．１比７９．７±１２．７，Ｐ均＜０．０１）。结论小儿消化性溃疡时胃酸分泌增多，夜间胃酸分泌明显多于白天。

Objective To investigate the alterations of gastric luminal pH in children with peptic ulcer. Methods Ambulatory 24 hr gastric pH monitoring was studied in 25 cases of peptic ulcer confirmed by gastroscopy, and 25 healthy children served as controls.Results No significant difference in any parameters was found between gastric ulcers and duodenal ulcers. Gastric mean pH and median pH were significantly lower in patients than in controls (1.8 ± 0.5 vs 2.3 ±0.6, 1.4±0.4 vs 1.7±0.5, P <0.01 and <0.05, respectively),while the percentages of time of gastric pH<2 and <3 were higher than those in controls (74.8±13.7 vs 62.8±15.2, 85.9±8.6 vs 74.2±13.1, P <0.01). Gastric mean pH and median pH in patients were significantly lower during night than during daytime (1.6±0.5 vs 2.1±0.5,1.3±0.4 vs 1.6±0.5, P <0.01), while the percentages of time of gastric pH<2 and <3 were higher than those during daytime (83.2±14.0 vs 66.2±19.9, 92.1±8.1 vs 79.7±12.7, P <0.01). Conclusion Gastric acid secretion is elevated in children with both gastric ulcer and duodenal ulcer, in particular during night. This study reveals that it is important to inhibit the gastric acid secretion during the night for the treatment of peptic ulcer in children.