摘要
[目的]观察马来酸曲美布汀对伴有无效食管动力的胃食管反流病患者食管运动功能的影响。[方法]对经内镜、24h食管pH-阻抗监测诊断为胃食管反流病,并行高分辨率食管压力测定(high resolution manometry,HRM),依据芝加哥3.0版标准诊断为无效食管动力的16例患者,给予马来酸曲美布汀0.2g tid、埃索美拉唑20mg、bid治疗2周后复查HRM,比较治疗前后下食管括约肌静息压(LESP)、食管体部各段波幅及时限、吞咽成功率、失蠕动比例、弱蠕动比例以及远端收缩积分(DCI)值等指标的变化。[结果]16例患者治疗前后LESP变化差异无统计学意义(P>0.05),在LESP明显降低的7例患者中,与治疗前相比,治疗后LESP明显增加[(1.8±0.9)mmHg(1mmHg=0.133kPa)∶(8.2±5.4)mmHg],差异有统计学意义(P<0.05);液体吞咽中,食管中段收缩波幅较治疗前明显增加[(33.7±11.4)mmHg∶(42.7±19.9)mmHg)],P<0.05;黏性吞咽中,食管远端收缩波幅较治疗前明显增加[(44.7±18.4)mmHg∶(57.5±23.4)mmHg],P<0.05;液体吞咽时,失蠕动比例较治疗前均显著下降,P<0.05;液体及黏性吞咽时,DCI值均较治疗前明显增加,P<0.05。在液体吞咽时,吞咽成功率较治疗前增加,差异有统计学意义,P<0.05。[结论]马来酸曲美布汀可能增加合并下食管括约肌低压的GERD患者的LESP,通过增加食管体部收缩波幅,改善合并无效食管动力的GERD患者食管体部的廓清功能。
[Objective]To observe the effect of trimebutine maleateon on the esophageal motility of gas- troesophageal reflex disease （GERD） patients with ineffective esophageal motility （IEM）. l-Methods] GERD Patients diagnosed by endoscopy,24 hours esophageal pH-impedance monitoring accepted the high-resolu- tion esophageal manometry examination. The patients diagnosed ineffective esophagus motility （according to chicago standard version 3.0） were given esomeprazole 20 mg twice daily combined trimebutine mal- eateon 0.2 g three times daily for 2 weeks. Then the HRM were carried out again. The changes of the LES resting pressure,the contraction amplitude and duration of esophageal body, the percentage of weak and failed peristalsis, DCI value and bolus clearance rate were analyzed. [Results] Sixteen patents were en- rolled. There was no significant differences in LESP between baseline and after treatment,but the LESP in 7 patients which was extremely lower than the normal were increased after treatment（1.8±0.9]mmHg ： [8.2±5.4]mmHg,P〈0. 05）. Liquid swallowing test showed that the treatment significantly increased middle esophageal contraction amplitude（[33.7±11.4]mmHg ： [42.7± 19.92mmHg,P〈0.05）. Viscous swallowing test showed that the treatment significantly increased the distal esophageal contraction ampli- tude（E44.7±18.4]mmHg ： [57.5±23.4〈mmHg,P〈0.05）. In liquid swallowing test,the treatment sig- nificantly decreased the percentage of failed peristalsis（P〈0.05）and increased the DCI value both in liquid or viscous swallowing（P〈0.05）. Bolus clearance rate was increased than baseline in liquid swallowing test （P〈0.05）. [Conclusion]Trimebutine maleateon may increase the esophageal body motility and clearance function,and may improve the LESP which is significantly lower than the normal in GERD patients with IEM.
出处
《临床消化病杂志》
2016年第3期170-174,共5页
Chinese Journal of Clinical Gastroenterology
关键词
胃食管反流病
马来酸曲美布汀
无效食管动力
gastroesophageal reflux disease
trimebutine maleateon
ineffective esophageal motility
