非重度反流性食管炎消化间期和消化期食管运动功能探讨  

Appraisal of esophageal motor function during interdigestive and digestive periods in non-severe reflux esophagitis

作　　者：刘会敏[1] 柯美云[1] 王智凤[1] 谷成明[1] 陈元方[1] 

机构地区：[1]中国协和医科大学中国医学科学院北京协和医院,100730

出　　处：《中华消化杂志》1997年第S1期34-37,共4页Chinese Journal of Digestion

摘　　要：目的：探讨非重度反流性食管炎（NSRE）的发病机制。方法：对10例（NSRE）患者和10名健康人（HS）进行同步胃窦、下食管括约肌（LES）和食管体部连续测压5小时，观察在消化间期和消化期食管功能．结果：NSRE和HS组的LES压力变化类似，在移行性复合运动（MMC）I期时，LESP较低，分别为23．3±3．0和16．1±2．7（mmHgNS），MMCⅡ期时升高为29．2±3．7和30．5×4．1（NS），而MMCⅢ期明显升高为53．4±6．1和43．4±6．0（与Ⅰ期比，P＜0．001，与Ⅱ期比，P＜0．01）。餐后1、2小时明显下降（与Ⅰ期、Ⅲ期比，P＜0．01，P＜0．001）。NSRE组的食管原发性蠕动功能异常，特别在食管远段表现为蠕动缺乏和蠕动不完全（包括蠕动波幅降低，时限延长和速度减慢）。结论：（1）消化间期和消化期对HS和NSRE患者的LES均有显著影响，（2）食管远段蠕动功能障碍可能是NSRE发病的主要机制。Objective: The study was to explore the lower esophageal sphincter (LES) and esophageal peristaltic function in patients with non-severe reflux esophagitis (NSRE) during interdigestive and digestive period. Methods: 10 patients with NSRE(Ⅰ- Ⅱ) and 10 healthy subjects (HS) participated in this study, the antral, LES and esophageal manomatry were performed continusly for 5 hours. Results: (1) LESPs during the phase Ⅰ, Ⅱ and Ⅲ of migrating motor comlex (MMC) were 23.3±3.0, 29.2±3.0, 53.4±6.1 mmHg (M±SE, vs MMC Ⅰ, P<0.001, vs MMC Ⅱ, P<0.05) in HS and 16.1±2.7, 30.5±4.1, 43.4±6.0 mmHg (vs MMC Ⅰ, P<0.001, vs MMC Ⅱ, P<0.05) in NSRE. LESPwas significantly decreased after meal in HS (11.8±2.8 mmHg, vs phase Ⅰ, P<0.01, vs phase Ⅲ P<0.001) and in NSRE (13.8±13.4mmHg, vs phase Ⅰ, P<0.01, vs phase Ⅲ, P<0.001). (2) The distal esophageal peristaltic function in NSRE showed abnormalities including amplitude, duration, and velocity of peristaltic contractions. A perfusion of 5ml of saline or 0.1mmol HCl had not produced difference in secondery peristalsis. Conclusions: Changes of LESP are similar in HS and NSRE groups, MMC cycle and meal significantly influence LESP level in both groups. Abnormality of esophageal primary peristalsis may result in delayed acid clearance and play an important role in the pathogenesis of NSRE.

关 键 词：反流性食管炎 食管测压 移行性复合运动 

分 类 号：R571[医药卫生—消化系统]