健康人食管测压及影响因素多中心研究  

Normative values of the esophageal manometry and its influential factors in the healthy subjects： a multiple center study in China

作　　者：王智凤[1] 孙晓红[1] 宋志强[1] 赵煜[1] 柯美云[1] 朱有玲[2] 王学勤[2] 罗金燕[2] 谢小平[1] 候晓华[3] 邹多武[4] 

机构地区：[1]中国医学科学院北京协和医院消化科,,100730 [2]西安交通大学第二附属医院消化科 [3]武汉协和医院消化科 [4]上海长海医院消化科

出　　处：《中华消化杂志》2012年第1期14-18,共5页Chinese Journal of Digestion

摘　　要：目的建立不同年龄组食管动力参数正常值及测定方法。方法应用气液压毛细灌注系统测定3个不同年龄组（Ⅰ组18～39岁，Ⅱ组40～59岁，Ⅲ组≥60岁）健康志愿者食管动力参数。同时观察本测定方法对下食管括约肌（LES）检测的重复性和稳定性。结果实际人组162名，Ⅰ组62名，Ⅱ组73名，Ⅲ组27名。三组间下食管括约肌长度（LESL）、呼气末下食管括约肌压力（LESP）、LESP平均值、残余压、下食管括约肌松弛率（LESRR）差异无统计学意义（P〉0．05）。Ⅰ组吸气末LESP为（28．98±1．11）mmHg，明显低于Ⅲ组[（34．35±1．96）mmHg，P〈0．05]。Ⅰ组跨膈压为（9．55±0．62）mmHg，明显低于Ⅱ组[（13．05±0．76）mmHg，P〈0．05]。三组食管体部远端和近端收缩波幅和时限差异无统计学意义（P〉0．05）。Ⅲ组上食管括约肌压力（UESP）明显低于Ⅰ组、Ⅱ组（P〈0．05）。重复性比较，Ⅰ组、Ⅱ组第2次呼气末LESP明显高于第1次（P〈0．05）。远端食管蠕动收缩波幅女性明显高于男性（P〈0．05），近端食管蠕动收缩波幅女性与男性无明显差别（P〉0．05）。结论得到不同年龄组食管动力参数的正常值。LES的动力参数不随年龄的增长而变化。而食管体部蠕动收缩能力在40～59岁年龄组最强。老年人UESP明显下降。检测前让受试者有足够的适应时间，有利于得到准确、可靠的LES的动力参数。Objective To establish normative values of esophageal manometry in different age groups and standard test method. Methods The values of esophageal manometry were tested in healthy subjects of 3 different age groups （Group Ⅰ： 18-39 years, Group Ⅲ ： 40-59 years, Group Ⅲ ： ≥60 years） with pneumohydraulic capillary perfusion system. The repeatability and stability of this method in lower esophageal sphincter （LES） testing were observed. Results There were no significant differences of IrES length （LESL）, LES pressure （LESP） at the end of expiration, average LESP, residual pressure of LES and IrES relaxation rate （LESRR） in three groups （P〉.05）. The LESP at the end of inspiration in Group Ⅰ （28.98±1.11） mm Hg was significantly lower than that of Group Ⅲ （34.35±1.96） mm Hg （P〈0. 05）. Trandiaphragmatic pressure （Pdi） in Group I （9.55±0.62） mm Hg was significantly lower than that of Group Ⅱ （13. 05±0. 76） mm Hg （P〈0. 05）. There were no significant differences in contraction amplitude and duration of proximal and distant esophagus in 3 groups （P〉0.05）. UES pressure （UESP） of Group Ⅲ was significantly lower than that of Group Ⅰ and Ⅱ （P〈0.05）. As for repeatability, the second recording of LESP in Group Ⅰ and Ⅱ were significantly higher than first recording （P〈0. 05）. Amplitude of distant esophageal peristaltic contraction （DEPC） of female was significantly higher than of male （P〈0.05）. However, there was no significant difference in amplitude of proximal esophageal peristaltic contraction （PEPC） between femal and male （P〉0.05）. Conclusions The normative values of esophageal manometry in different age groups have been obtained. The dynamic parameters of LES do not change with age. Between age 40 to 59 years old, the contraction of esophageal body is strongest. UESP decreases significantly in old people. If the subjects have enough time to adapt before test, it will help to get accurate and re

关 键 词：食管括约肌 下段 年龄因素 食管胃接合处 测压法 蠕动 

分 类 号：R571[医药卫生—消化系统]