非糜烂性反流病患者食管阻抗基线与酸暴露、上皮细胞间隙的相关研究  

Correlation between esophageal impedance baseline, acid exposure and epithelial intercellular space in NERD patients

作　　者：刘贝妮[1,2] 姚树坤[1,2] 张艳丽[1] 王淼[1] 杜时雨[1] 刘亮[1,2] 

机构地区：[1]中日友好医院消化内科,北京100029 [2]中国医学科学院北京协和医学院研究生院,北京100730

出　　处：《解放军医学院学报》2015年第3期204-207,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家科技部"十二五"支撑计划(2014BAI08B02)~~

摘　　要：目的通过对非糜烂性反流病（non-erosive reflux disease,NERD）患者的食管阻抗基线与酸暴露、上皮细胞间隙相关性分析,探讨食管阻抗监测评价食管黏膜屏障功能的临床应用价值。方法选取2013-2014年我院门诊的非糜烂性反流病患者46例和健康志愿者18例,行24 h食管p H＋阻抗监测和胃镜检查。两项检查相隔1周。胃镜下活检食管下段组织2块,测量食管黏膜上皮细胞间隙。结果 NERD患者的酸暴露时间显著高于健康对照组[4.1（0.2-0.6）%vs 0.4（1.0-5.3）%,P〈0.001],食管远端阻抗基线值显著低于健康对照组[（2 943±759）Ωvs（3 968±1 076）Ω,P〈0.001],食管上皮细胞间隙较健康对照组显著增宽[（1.01±0.20）μm vs（0.67±0.14）μm,P〈0.001]。NERD患者阻抗基线值与酸暴露呈负相关（r=-0.35,P=0.016）,与上皮细胞间隙呈负相关（r=-0.58,P=0.002）。结论 NERD患者食管阻抗基线降低与酸暴露、上皮细胞间隙增宽有相关性,阻抗监测可用于评估食管黏膜完整性。Objective To assess the clinical application value of impedance monitoring in the evaluation of mucosal barrier function by correlation analysis between esophageal impedance baseline and acid exposure, epithelial intercellular spaces （ICS） in patients with non-erosive reflux diseases （NERD）.Methods A total of 46 NERD patients admitted to China-Japan Friendship Hospital from 2013 to 2014 and 18 healthy controls were enrolled in the study. All patients bad underwent 24 h pH-impedance monitoring and gastroendoscopy one week apart. Two biopsies were taken from the distal esophageal wallsand ICS was quantified by histochemical technique. Results Patients with NERD had longer acid exposure time [4.1 （0.2 - 0.6）% vs 0.4 （1.0 - 5.3）%,P〈0.001], lower impedance baseline of distal esophagus [（2 943±759）Ωvs （3 968±1076）Ω,P〈0.001] and wider ICS [（1.01±0.20）μmvs （0.67±0.14）μm,P〈0.001] than controls. Baseline impedance was negatively correlated with AET （r=-0.35,P=0.016） and ICS （r=-0.58,P=0.002） in NERD patients.ConclusionThe decrease of distal esophageal impedance baseline in NERD is associated with acid exposure and dilated intercellular spaces. Impedance monitoring can be used to assess esophageal mucosal integrity.

关 键 词：非糜烂性反流病 阻抗 食管上皮细胞间隙 酸暴露 食管黏膜 

分 类 号：R571[医药卫生—消化系统]