摘要
目的探讨胃食管反流病(gastroesophageal reflux disease,GERD)患者血β内啡肽(β-endorphin,β-EP)与食管动力及反流情况的关系。方法选取2015年9月至2020年8月于我院消化内科住院的诊断为GERD的患者73例,依据高分辨食管测压(HRM)结果,将患者分为食管下括约肌压力(lower esophageal sphincter pressure,LESP)正常组和LESP减低组,无蠕动中断组和蠕动中断组;应用24 h pH-阻抗监测了解酸暴露时间、最长反流时间、反流次数、反流物性质关系情况;测定空腹血β-EP的含量,以上结果在LESP正常组和LESP减低组、无蠕动中断组和蠕动中断组之间进行比较。结果蠕动中断组血β-EP含量为7.10(5.32,11.02)ng/ml,无蠕动中断组血β-EP含量为9.62(6.37,14.53)ng/ml,两组间差异有统计学意义(P=0.031)。LESP正常组中血β-EP含量为9.62(7.31,14.53)ng/ml,LESP减低组中血β-EP含量为7.31(5.37,12.65)ng/ml,两组间比较,差异有统计学意义(P=0.026)。在无蠕动中断组患者中,血β-EP含量与最长反流时间、酸暴露时间呈负相关,相关系数分别为-0.331(P=0.030)及-0.340(P=0.026)。在LESP正常组中,血β-EP与最长反流时间呈负相关,相关系数为-0.401(P=0.042)。在LESP减低组中,血β-EP与气体反流次数呈负相关,相关系数为-0.334(P=0.022)。结论LESP正常、无食管蠕动中断的GERD患者血β-EP含量较高,且血β-EP的含量可能还与最长反流时间、酸暴露时间、气体反流次数相关。
Objective To investigate the relationship betweenβ-endorphin(β-EP)and esophageal motility and reflux in patients with gastroesophageal reflux disease(GERD).Methods 73 patients with GERD were enrolled from Sep.2015 to Aug.2020,and divided into lower esophageal sphincter pressure(LESP)normal group and LESP reduction group,intact peristalsis group and fragmented peristalsis group.The 24 h pH-impedance monitoring was used to learn the acid exposure time,long-term reflux episodes,reflux episodes and reflux properties;fasting serumβ-EP level was measured.The above results were compared between LESP normal group and LESP reduction group,or intact peristalsis group and fragmented peristalsis group.Results The level of serumβ-EP was 7.10(5.32,11.02)ng/ml in fragmented peristalsis group and 9.62(6.37,14.53)ng/ml in intact peristalsis group;9.62(7.31,14.53)ng/ml in LESP normal group and 7.31(5.37,12.65)ng/ml in LES reduction group.There were significant differences between the two groups(P=0.031,P=0.026,respectively).The serumβ-EP level was negatively correlated with the long-term reflux episodes and acid exposure time in the intact peristalsis group,with correlation coefficients of-0.331(P=0.030)and-0.340(P=0.026),respectively.In the LESP normal group,serumβ-EP was negatively correlated with the long-term reflux episodes,and the correlation coefficient was-0.401(P=0.042).In the LESP reduction group,serumβ-EP was negatively correlated with the number of gas reflux episodes,the correlation coefficient was-0.334(P=0.022).Conclusion The level of serumβ-EP in GERD patients with normal LESP or esophageal intact peristalsis is higher.It may also be related to the long-term reflux episodes,acid exposure time and gas reflux episodes.
作者
陈婧
冯跃
宾楚轩
郭宝娜
郭子皓
展玉涛
张川
CHEN Jing;FENG Yue;BIN Chuxuan;GUO Baona;GUO Zihao;ZHAN Yutao;ZHANG Chuan(Department of Gastroenterology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《胃肠病学和肝病学杂志》
CAS
2021年第6期632-636,共5页
Chinese Journal of Gastroenterology and Hepatology
基金
北京市医院管理中心消化内科学科协同发展中心专项经费资助(XXT09)。
关键词
胃食管反流病
β-内啡肽
食管下括约肌
高分辨食管测压
24
h食管pH-阻抗监测
Gastroesophageal reflux disease
β-endorphin
Lower esophageal sphincter pressure
High-resolution esophageal manometry
24 h esophageal pH impedance monitoring
