探讨P物质（SP）和降钙素基因相关肽（CGRP）以及炎症因子在非糜烂性胃食管反流病发生发展中的机制。

收集2018年10月至2019年4月间于新疆维吾尔自治区人民医院住院就诊的非糜烂性反流病（NERD）患者25例和健康受试者10例。NERD患者为NERD组，健康受试者为对照组。所有患者及健康受试者均行GerdQ评分、24 h pH监测、高分辨率食管测压监测酸反流情况，并于内镜下取食管齿状线上3 cm处的局部黏膜行组织病理学检查和定量RT-PCR检测SP、CGRP及炎症因子的mRNA表达量。计量资料使用均数±标准差（

食管24 h pH监测显示，NERD组患者弱酸反流次数、酸反流次数、食管近端酸反流及DeMeester评分等指标明显高于对照组，t值分别为-2.365，-2.145，-2.782，-2.776，P值分别为0.025，0.021，0.021，0.017，具有统计学意义（P＜0.05）。组织病理学检查发现，NERD组食管黏膜可见明显的中性粒细胞浸润和炎症前反应，并且炎症损伤评分明显高于对照组，P值0.003，两组间比较具有统计学意义（P＜0.01）。NERD组SP及CGRP的mRNA相对表达量与对照组相比显著上升，P值分别为0.0046，0.002，并具有统计学意义（P＜0.01）。NERD组食管粘膜中，白细胞介素-1β、白细胞介素-6、干扰素-γ以及肿瘤坏死因子-α的mRNA相对表达量明显增高，P值分别为0.0034，0.0043，0.004，0.0028，两组间具有统计学意义（P＜0.01）。通过Pearson相关性分析发现，NERD组酸反流评分（DeMeester）分别与SP、CGRP及炎症因子的mRNA表达有强相关关系，P值分别为0.003，0.000，0.002，0.005，0.004，0.000，均具有统计学意义（P＜0.01），相关系数（r）分别为0.678，0.686，0..90，0.482，0.374，0.415。

SP、CGRP及炎症因子在NERD患者中表达量明显升高，可能与酸反流引起食管酸敏感性增加以及炎症发生有关。

To explore the mechanism of substance P (SP), calcitonin gene-related peptide (CGRP) and inflammatory cytokines in the development of non erosive reflux disease.

A total of 25 NERD patients and 10 normal controls were enrolled. All the subjects underwent GERDQ score, 24 h pH monitoring, high resolution esophageal manometry monitoring and endoscopic removal of the local mucosa at 3 cm of the esophageal dentate line as specimens. The expression of SP, CGRP and inflammatory cytokines (IL-1β, IL-6, IFN-γ, TNF-α) was detected by HE staining and RT-PCR.

24 h esophageal pH monitoring showed that the number of weak acid reflux (4＜pH＜7), acid reflux (pH≤4), acid reflux (%) in proximal esophagus and DeMeester score in NERD group were significantly higher than in control group the t values were -2.365, -2.145, -2.782 and -2.776, and the P values were 0.025, 0.021, 0.021 and 0.017, respectively (P＜0.05). H&E staining showed that there were obvious neutrophil infiltration and pre-inflammatory reaction in esophageal mucosa of NERD group, and the score of inflammation injury was significantly higher than that of control group,the P value were 0.003 (P＜0.01). The relative expression of SP and CGRP in NERD group was significantly higher than that in control group, the P values were 0.0046,0.002, respectively (P＜0.01). In NERD group, the relative expressions of IL-1β, IL-6, IFN-γ and TNF-α in esophageal mucosa were significantly increased,P values were 0.0034, 0.0043, 0.004 and 0.0028, respectively (P＜0.01). Pearson correlation analysis showed that the acid reflux score (DeMeester) in NERD group was positively correlated with the expression of SP, CGRP and inflammatory factors (IL-1β, IL-6, IFN-γ, TNF-α) respectively. The P values 0.003, 0.000, 0.002, 0.005, 0.004 and 0.000, respectively (P＜0.01), the correlation coefficients were r=0.678, 0.686, 0.90, 0.482, 0.374 and 0.415, respectively.

The expression of SP, CGRP and inflammatory cytokines in NERD patients increased significantly, which may be closely related to the increase of esophageal acid sensitivity caused by acid reflux and the occurrence of inflammation.