非糜烂性反流病的食管动力与胃动素相关性研究  

Correlation of esophageal motility and motilin of non-erosive reflux disease

作　　者：冯爱花[1] 王沁[1] 陈锐[1] 

机构地区：[1]兰州大学第一医院消化内科,甘肃兰州730000

出　　处：《胃肠病学和肝病学杂志》2007年第3期213-215,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的从胃肠激素-胃动素与食管动力方面探讨非糜烂性反流病(NERD)的发病机制。方法健康对照14例、反流性食管炎(RE)和NERD各30例参与试验。RE、NERD经症状评估和内镜诊断、结合24h食管pH动态监测、质子泵抑制剂(PPI)试验诊断入组。采用四通道胃肠功能仪检测食管动力,以下食管括约肌压力(LESP)、食管蠕动波推进速度、食管体部蠕动压力、下食管括约肌的松弛状况来表示;用放射免疫方法检测血浆胃动素(motilin,MTL)水平。结果NERD组胃动素水平较正常对照组明显降低(P<0.01),与RE组比较无显著性差异(P>0.05);LESP在NERD组、RE组、正常对照组间无显著性差异(P>0.05);食管蠕动波推进速度、食管体部蠕动压力、下食管括约肌的松弛状况在各组间无显著性差异(P>0.05);NERD组、RE组、正常对照组分别分析胃动素与各项动力学指标相关性,P均大于0.05。结论NERD患者的食管动力学改变与RE、正常对照并无区别,食管动力学各项指标与胃动素水平也不存在相关性;NERD、RE组胃动素水平明显低于正常对照组,胃动素在NERD的发生机制中可能起一定的作用。Objective To study the machenism of non-erosive reflux disease by evaluating the correlation of gut hormon-motilin and esophageal motility. Methods Thirty NERD patients diagnosed by symptom evaluation, endoscopy, ambulatory 24h pH monitoring and proton pump inhibitor trial, and forty-four control subjects including 30 patients with reflux esophagitis and 14 normal volunteers were enrolled in this study. Using four-catheter gastrointestinal functional instrument, low esophageal sphincter pressure （LESP）, esophageal peristaltic driving velocity, peristaltic pressure of esophageal body and the relaxation state of LES were detected as the evaluation index. Blood plasma level of motilin （MTL） was tested by radioimmunity（RI） method. Results MTL level of patients with NERD was obviously decreased compared with normal controls and RE group （P 〈0.01 ）. No difference was found in three groups about all motility indexes （P 〉 0.05）. Conclusion Our findings suggest that the motilin might play an important role in the pathogenesis of NERD.

关 键 词：非糜烂性反流病 胃动素 食管动力 

分 类 号：R571[医药卫生—消化系统]