摘要
目的 了解非糜烂性反流病（NERD）患者酸诱导的食管阻抗动态变化及其与食管上皮细胞间隙增宽之间的关系.方法 选取2013年9月至2014年7月NERD患者35例和健康对照者20名,行24 h食管多通道腔内阻抗-pH（MII-pH）监测、酸灌注试验和胃镜检查.胃镜下在齿状线上2 cm处的前、后壁各取一块黏膜组织,HE染色后用软件测量食管上皮细胞间隙.统计学处理采用t检验,相关性分析采用Pearson相关分析.结果 NERD患者食管远端阻抗基线和阻抗恢复速率显著低于健康对照组,分别为（2 998±701）Ω比（3 880±1 054）Ω、（30.1±14.0） Ω/min比（53.0±14.5）Ω/min,差异有统计学意义（t=3.65、5.41,P均＜0.01）;食管上皮细胞间隙较健康对照组显著增宽,为（1.03±0.20） μm比（0.66±0.14） μm,差异有统计学意义（t=6.57,P＜0.01）.酸灌注试验阳性的患者食管阻抗基线和阻抗恢复速率显著低于酸灌注试验阴性的患者,分别为（2 755±680）Ω比（3 411±536）Ω、（25.4±13.0）Ω/min比（33.4±9.8）Ω/min,差异有统计学意义（t=2.99、2.03,P均＜0.05）.阻抗恢复速率与上皮细胞间隙呈负相关（r=-0.70,P＜0.01）.结论 反复的反流损伤和黏膜修复减慢可能是NERD患者食管黏膜完整性受损的原因.食管阻抗基线的变化在一定程度上可反映食管黏膜完整性受损的程度.
Objective To investigate the correlation between dynamic changes in esophageal impedance and dilated intercellular space （DIS） of patients with acid-induced non erosive reflux disease （NERD）.Methods From September 2013 to July 2014,a total of 35 patients with NERD and 20 healthy controls were selected and underwent 24 h multichannel intraluminal impedance and pH monitoring （MII-pH monitoring）,acid perfusion test and gastroendoscopy examination.One piece of mucosa tissue was taken under gastroendoscope from the anterior and posterior walls at 2 cm above the dentate line of the esophagus.Intercellular space （ICS） of the esophageal epithelia cells was measured by software after hematoxylin and eosin staining.t test and variance analysis were performed for statistical analysis.Pearson correlation analysis was used for correlation analysis.Results Impedance baseline of distal esophagus and impedance recovery rate of patients with NERD were lower than those of healthy control group,which were （2 998±701） Ω vs （3 880±1 054） Ω and （30.1±14.0） Ω/min vs （53.0±14.5） Ω/min,and the differences were statistically significant （t=3.65,5.41;both P＜0.01）.Compared with healthy control group,ICS of the esophageal epithelial cells was obviously wider （1.03 ± 0.20） μm vs （0.66±0.14） μm,and the difference was statistically significant （t=-6.57,P＜0.01）.Impedance baseline of esophagus and impedance recovery rate of patients with positive acid perfusion test were lower than those of patients with negative acid perfusion test,which were （2 755±680） Ωvs （3 411±536） Ω and （25.4±13.0） Ω minvs （33.4±9.8） Ω /min,and the differences were statistically significant （t =2.99,2.03;both P＜0.05）.The correlation between impedance recovery rate and ICS was negative （r=-0.70,P＜0.01）.Conclusions Recurrent reflux induced injury and delayed mucosal headline may be the factors of impaired mucosal integrity in patients with NERD.The changes esophageal of impeda
出处
《中华消化杂志》
CAS
CSCD
北大核心
2015年第5期305-308,共4页
Chinese Journal of Digestion
基金
国家科技部十二五支撑计划项目（2014BAI08B02）
关键词
非糜烂性反流病
酸暴露
阻抗基线
细胞外隙
黏膜完整性
Non-erosive reflux disease
Acid exposure
Impedance baseline
Extracellular space
Mucosal integrity
