Ⅱ型贲门失弛缓症患者食管动力学特征的高分辨率测压分析  

High resolution manometry analysis of esophageal motility in type Ⅱ achalasia patients

作　　者：郑晓敏[1] 李仁君[1] 李敏[1] 

机构地区：[1]安徽医科大学附属安庆医院消化内科,安徽省安庆市246001

出　　处：《中华消化内镜杂志》2014年第5期249-252,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨Ⅱ型贲门失弛缓症（AC）患者的食管动力学特征，并评估高分辨率食管测压（HRM）检测的临床应用价值。方法收集20例Ⅱ型AC患者（观察组）和15例健康志愿者（对照组）的HRM检测结果，对比分析两组食管动力学指标的差异。结果观察组患者食管体部以无传导性同步收缩波为主（88．2％，176／200），对照组均为正常食管蠕动波。食管下括约肌静息压、4s完整松弛压力和食管上括约肌残余压观察组分别为（37．6±12．8）mmHg（1mmHg=0．133kPa）、（31．5±13．4）mmHg和（14．0±3．8）mmHg，均明显高于对照组的（23．7±5．6）mmHg（t=3．925，P=0．000）、（10．5±4．3）mmHg（t=5．835，P=0．000）和（7．9±4．5）mmHg（t=4．325，P=0．000）；食管下括约肌松弛率观察组为（23．6±19．6）％，明显低于对照组的（58．1±16．7）％（t=-5．491，P=0．000）。食管下括约肌长度和食管上括约肌静息压两组间差异均无统计学意义（P〉0．05）。结论Ⅱ型AC患者以无传导性同步收缩波和4s完整松弛压力增高为HRM的特征性表现，HRM检测有助于对AC进行早期诊断、再分类及预期疗效的评估。Objective To investigate the characteristics of esophageal motility in patients with type Ⅱ achalasia and evaluate the clinical value of high resolution manometry （HRM）. Methods A total of 20 patients with type Ⅱ achalasia（observation group） and 15 healthy controls（control group） were enrolled for high resolution manometry. The characteristics of esophageal motility of two groups were compared. Results The motor pattern of esophageal body of observation group was mostly non-conductive synchronous contraction（88.2% , 176/200） , but in control group it was normal esophageal peristalsis. Lower esophageal sphinc-ter pressure, 4 s integrated relaxation pressure（4s IRP） and upper esophageal sphincter residual pressure in observation group were （ 37.6 ± 12. 8 ） mmHg, （ 31.5 ± 13.4 ） mmHg and （ 14.0 ± 3.8 ） mmHg, respectively, which were higher than those of the control group, （23.7 ± 5.6） mmHg（ t = 3. 925 ,P = 0. 000） , （ 10. 5 ± 4. 3 ） mmHg （ t = 5. 835, P = 0. 000 ） and （7. 9 ± 4. 5 ） mmHg （ t = 4. 325, P = 0. 000 ）. The lower esophageal sphincter relaxation rate in observation group was（23.6 ± 19. 6）%, which was lower than that of the control group（ 58. 1 ± 16. 7 ）% （t = -5. 491, P = 0. 000 ）. There was no significant difference in lower esophageal sphincter length and upper esophageal sphincter pressure between type Ⅱ aehalasia group and control group （P 〉 0. 05）. Conclusion The characteristics of esophageal manometry in type Ⅱ achalasia is non-conductive synchronous contraction and elevated 4s IRP, and HRM contributes to early diagnosis, reclassification and evaluation of expected outcome in aehalasia.

关 键 词：食管失弛症 测压法 食管动力学 

分 类 号：R571[医药卫生—消化系统]