非重度反流性食管炎患者消化间期和消化期食管运动功能的探讨  

Esophageal Motor Patten During Fasting and Postprandial States 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消化内科,100730

出　　处：《胃肠病学》1997年第1期19-22,共4页Chinese Journal of Gastroenterology

摘　　要：为探讨非重度反流性食管炎(NSRE)的发病机制,本研究对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,观察消化间期和消化期的食管功能。结果显示,NSRE和HS组的LES压力变化类似,在移行性复合运动(MMC)Ⅰ期时,LES压力较低,分别为23.3±3.0和16.1±2.7(NS),MMCⅡ期时升高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<O.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),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),研究提示:(1)消化闻期和消化期对HS和NSRE病人的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。Background/Aims: To explore the lower esophageal sphincter (LES) and esophageal peristaltic function in patients with non-severe reflux esophagitis (NSRE) during fasting and postprandial states. Methods: Ten patients with NSRE (Ⅰ - Ⅱ) and 10 healthy subjects (HS) participated in this study. The antral, LES and esophageal manometry was performed for 5 hours, 3hs for fasting and 2hs for postprandial state. Results: (1)LES pressures during the phase Ⅰ , Ⅱ and 333 of migrating motor comlex (MMC) were 23.3±3.0, 29.2±3.0 and 53.4±6.1mmHg (x -sx , vs MMC Ⅰ, P<0.001; vs MMC Ⅱ, P<0.05) in NSRE. LES pressure significantly decreased after meal in HS (11.8±2.8mmHg, vs phase Ⅰ , P<0.01, phase Ⅲ, P<0.001) and in NSRE (13.8±3.4mmHg, vs phase Ⅰ , P<0.01, phase Ⅲ, P<0.001). (2)The distal esophageal peristaltic function in NSRE showed abnormalities including peristaltic contraction amplitude, duration, and velocity. A perfusion of 5ml of saline or 0.1mmol HC1 did not cause difference of secondery peristalsis. Contusions: Variations of LES pressure were similar in HS and NSRE groups, MMC cycle and meal significantly influence LES pressure level in both groups. Dysfunction of esophageal primary peristalsis may result in acid clearance delay and play a more 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]