摘要
目的分析胃食管反流病(GERD)患者胃食管反流及食管动力特征。方法对61例伴难治性胃食管反流症状的GERD患者进行24-h阻抗-pH(MⅡ-pH)及固态高分辨率测压(HRM)检查,观察异常反流及食管动力障碍情况,分析反流参数与HRM参数的相关性。结果所有患者完成MⅡ-pH监测,28例患者完成食管HRM。61例患者中,55例存在异常反流;其中,反流性食管炎(RE)26例、非糜烂性反流病(NERD)29例。RE患者酸反流的发生和无效吞咽次数较NERD患者多(P<0.05)。DeMeester评分与近段食管蠕动压力(PEP)、中段食管蠕动压力(MEP)和远端收缩积分(DCI)呈负相关(r=-0.525、-0.463和-0.417,P<0.05),酸反流次数与PEP、DCI和食管下括约肌的综合松弛压(IRP)呈负相关(r=-0.547、-0.431和-0.426,P<0.05),弱酸反流次数与MEP、远段食管蠕动压力、DCI和IRP呈负相关(r=-0.470、-0.391、-0.447和-0.632,P<0.05)。结论伴难治性反流症状的GERD患者,异常反流和食管动力障碍发生较多,且异常反流情况和食管动力障碍密切相关。
Objective To analyze the characteristics of gastroesophageal reflux and esophageal motility in the patients with gastroesophageal reflux disease（GERD）.Methods Sixty-one GERD patients with refractory reflux symptoms were detected by the examinations of 24-h impedance pH and high resolution manometry（HRM）.The gastroesophageal reflux and esophageal motility were observed.The relationship of reflux parameters and HRM parameters was analyzed.Results The 24-h impedance pH detection was completed in 61 patients and HRM was performed in 28 patients.The results showed that 55 cases were with anomalous reflux,of whom 26 cases were with reflux esophagitis（RE）and 29 cases were with nonerosive reflux disease（NERD）.The incidence rate of acid reflux and the number of patients with invalid swallowing were higher in the patients with RE than those in the patients with NERD（P〈0.05）.The score of DeMeester was negatively correlated to proximal esophageal peristaltic pressure（PEP）,middle esophageal peristaltic pressure（MEP）and distal contraction integral（DCI）（r=-0.525,-0.463 and -0.417,P〈0.05）.The times of acid reflux was negatively correlated to PEP,DCI and comprehensive relaxation pressure（IRP）（r=-0.547,-0.431 and-0.426,P〈0.05）.The times of weak acid reflux was negatively correlated to MEP,distal esophageal peristaltic pressure（DEP）,DCI and IRP（r=-0.470,-0.391,-0.447 and -0.632,P〈0.05）.Conclusion Abnormal reflux and esophageal motility disorder are more common in GERD patients with refractory reflux symptoms,in which abnormal reflux is closely related to motility disorder.
作者
姜柳琴
叶必星
王美峰
林琳
JIANG Liuqin;YE Bixing;WANG Meifeng(Department of Gastroenterology,First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,CHINA)
出处
《江苏医药》
CAS
2018年第8期905-908,共4页
Jiangsu Medical Journal
关键词
胃食管反流病
Gastroesophageal reflux disease
