摘要
目的分析胃食管反流病(GERD)三种亚型Barrett食管(BE)、糜烂性食管炎(EE)和非糜烂性反流病(NERD)患者食管24h pH监测与高分辨率食管测压结果,探讨不同亚型胃食管反流病食管酸暴露及动力学变化特点。方法收集2015年12月至2017年12月,新疆维吾尔自治区人民医院接受住院治疗的90例GERD患者的临床资料,其中BE组28例、EE组35例、NERD组27例,通过食管24h pH监测结果评价患食管酸暴露及反流特点,高分辨率食管测压检查评价食管动力学特点。结果 3组患者年龄及身体质量指数(BMI)等一般资料比较,差异无统计学意义(P> 0. 05);EE组患者24 h食管pH监测中pH≤4(酸反流)、4 <pH <7(弱酸反流)以及酸反流总事件数比BE组和NERD组较多,但差异均无统计学意义(P均> 0. 05);3组Demeester评分比较,差异无统计学意义(P> 0. 05);LES长度3组无明显差异,BE组LES静息压及残余压较EE组和NERD组稍高,但差异无统计学意义(P均>0. 05);3组在食管远端收缩积分比较,差异无统计学意义(P> 0. 05)。结论食管测酸检查在GERD临床亚型的鉴别方面并无显著差别;Barrett食管、糜烂性食管炎、非糜烂性反流病均存在抗反流屏障功能减退,但不同程度的食管粘膜损伤对食管动力学的影响并无差异。
ObjectiveTo investigate the characteristics of esophageal acid exposure and motility in patients with Barrett′s esophagus(BE),erosive esophagitis(EE),non-erosive reflux disease(NERD).MethodsRetrospectively analysed the high resolution manometry(HRM)and 24-hour ambulatory esophageal pH monitoring result of patients with BE,EE and NERD who were carefully selected according to the results of gastroesophageal reflux disease(GERD)questionnaire and endoscopy during December 2015 to December 2017 in People′s Hospital of Xinjiang Uyghur Autonomous Region.ResultsThe measurement of acidic(pH≤4)or weak acidic(4<pH<7)esophageal reflux showed no statistical difference between 28-sample BE group,35-sample EE group and 27-sample NERD group(P>0.05),nor did the DeMeester score or total reflux episodes(P>0.05).There was also no significant difference in the length of LES and DCI score between the 3 groups(P>0.05).Though the static pressure and residual pressure of the LES of BE group were slightly higher than that of the EE group and the NERD group,but the difference was not statistically significant(P>0.05).ConclusionOur findings suggest that acid measurement does not have a significant effect in identifying different clinical subtypes of GERD.Although the anti-reflux barrier function was damaged in different degrees in Barrett′s esophagus,erosive esophagitis,and non-erosive reflux disease all have,but the impact of esophageal mucosal injury on esophageal dynamics is not considerable.
作者
美丽克扎提.安扎尔
米热阿依.阿不都哈的尔
高峰
Meilikezhati·Anzhaer;Miriayi·Abudouhadier;Gao Feng(Department of Gastroenterology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处
《中华胃食管反流病电子杂志》
2018年第2期49-52,共4页
Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)
