pH监测正常与异常的非糜烂性反流病患者高分辨率食管测压特征分析  

Analysis of esophageal motility between patients with non-erosive reflux disease with normal pH and those with abnormal pH by high resolution manometry

作　　者：郑晓敏[1] 李敏[1] 汪文生[1] 张焰平[1] 李仁君[1] 

机构地区：[1]安徽医科大学附属安庆医院消化内科,安徽安庆246001

出　　处：《胃肠病学和肝病学杂志》2013年第3期232-234,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的应用高分辨率食管测压比较pH监测正常与异常非糜烂性反流病(NERD)患者的食管动力学特征。方法按标准选取具有典型胃食管反流症状的NERD患者35例和健康体检者10例,分别行上消化道内镜检查、24 h食管pH监测和高分辨率食管测压。依据动态pH监测Demeester评分将NERD患者分为pH监测异常组和pH监测正常组,比较3组患者食管动力的差异。结果 pH监测异常组食管下括约肌(LES)长度较对照组显著缩短(P<0.05),LES压力(LESP)显著降低(P<0.05),pH监测正常组与对照组比较则无明显差异。pH监测正常组和异常组均存在食管体部动力障碍,表现为食管远端收缩波波幅及远端收缩积分降低和有效蠕动比例减少,pH监测异常组改变更为明显。结论 pH监测不同NERD患者间存在食管动力特征差异,pH监测异常NERD组患者存在LES长度和压力异常,食管远端动力障碍更为明显。Objective To compare the characteristics of esophageal motility between patients with non-erosive reflux disease （NERD） with normal pH and those with abnormal pH by high resolution manometry. Methods 35 NERD pa- tients with typical gastroesophageal reflux symptoms and 10 healthy subjects were enrolled in trial. Each individual was evaluated by upper gastrointestinal endoscopy, 24-hour esophageal pH monitoring and high resolution esophageal mano- merry. Patients with non-erosive reflux disease were divided into normal and abnormal pH groups, according to the De- meester score. The characteristics of esophageal motility in 3 groups were compared. Results Compared with control group, length of lower esophageal sphincter （LES） was shorter and LES pressure was lower in abnormal pH group （P 〈 0.05） , but there were no significant differences between normal pH group and control group. Motility disorders in e- sophageal body appeared in both NERD subgroups and were manifested as lowering of distal esophageal contraction am- plitude and distal contractile integral and decreasing of effective peristalsis proportion, these disorders were more promi- nent in abnormal pH group than those in normal pH group. Conclusion Different esophageal motility characteristics were found in different NERD subgroups. Reduced LES length and pressure and more prominent distal esophageal motil- ity disorders were seen in abnormal pH group of NERD.

关 键 词：食管PH监测 非糜烂性反流病 高分辨率食管测压 

分 类 号：R573[医药卫生—消化系统]