摘要
目的:比较pH监测正常与异常内镜阳型胃食管反流病(gastroesophageal reflux disease,GERD)患者在食管动力学上的异同.方法:经内镜确诊反流性食管炎(reflux eso- phagitis,RE)或Barrett's食管患者共49例,依据动态pH监测DeMeester积分分为pH监测异常组和pH监测正常组.正常组12例,异常组37例,异常组有8名患者伴有裂孔疝,比较两组患者食管动力的不同.结果:两组比较pH监测正常组下食管括约肌静息压力(Lower esophageal sphincter Pressure,LESP)(P=0.036),食管体部中下点(P=0.048)及肛侧收缩幅度(P=0.017)高于pH监测异常组.剔除食管裂孔疝患者后,食管体部肛侧的收缩幅度仍有明显差异(P=0.035).结论:监测正常组LESP以及食管体部中下点及肛侧收缩幅度高于监测异常组,正常组由于其清除功能及屏障功能强于异常组导致反流甚难达到通常pH电极位置,或达到后很快被清除.
AIM： To compare the esophageal motility between patients with normal pH endoscopepositive gastroesophageal reflux disease （GERD） and abnormal pH endoscope-positive GERD.
METHODS： There were 49 patients with endoscope-positive gastroesophageal reflux disease （GERD）. Patients were divided into normal and abnormal pH groups, according to the De- Meester score. Thirty-seven patients were in the abnormal pH group （27 males, 10 females, mean age 56 ± 15 yr）, and the remainder were in the normal pH group （8 males, 4 females, mean age 51 ± 11 yr）. Eight patients in the abnormal group suffered from hiatus hernia at the same time.
RESULTS： No significant difference was found between the two groups in age and sex rate. The mean lower esophageal sphincter pressure （LESP） and the mean peristalsis amplitude in the middle-down esophagus body and anal lateral esophagus body in the normal pH group were higher than those in the abnormal group （P = 0.036, P = 0.048, P = 0.017）. When we analyzed patients with hiatus hernia, the mean peristalsis amplitude of the anal lateral esophagus was higher in the normal pH group than that in the abnormal group （P = 0.035）.
CONCLUSION： The mean LESP and peristalsis amplitude of middle-down esophagus body and anal lateral esophagus body in the normal pH group were higher than those in the abnormal group. Even when patients with hiatus hernia were not included, the results were close to the whole analysis. This shows why some patients with endoscope-positive gastroesophageal reflux disease appear normal pH profile. Stronger clearance ability of esophagus and barrier in the normal pH monitoring group may contribute to the phenomena.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第1期86-89,共4页
World Chinese Journal of Digestology
关键词
食管PH监测
胃食管反流
食管动力
下食管括约肌
Esophageal pH monitoring
Gastroesophageal reflux
Esophageal Motility
Lower esophageal sphincter
