30例贲门失弛缓症的临床症状与其食管测压相关性  

Correlation between the clinical symptoms of 30 cases achalasia of cardia and their high-resolution manometry parameters

作　　者：谢忱[1] 汤玉蓉[1] 王美峰[1] 姜柳琴[1] 施瑞华[2] 林琳[1] 

机构地区：[1]南京医科大学第一附属医院消化内科,210029 [2]东南大学附属中大医院消化内科

出　　处：《中华消化杂志》2015年第5期319-322,共4页Chinese Journal of Digestion

摘　　要：目的 探讨贲门失弛缓症（AC）患者的临床症状与高分辨率食管测压（HRM）参数的相关性.方法 回顾性分析30例AC患者的临床资料,应用Eckardt评分评估症状严重程度,应用HRM参数评估食管动力情况并根据芝加哥分型将患者分为3种类型.采用Mann-Whitney U检验对非正态分布的定量资料进行比较,采用Spearman相关系数分析症状评分与测压参数的相关性.结果 Ⅱ型患者反流症状评分重于Ⅰ型[2.50（1.00）比1.00（1.50）,U=56.000,P＜0.05];完整松弛压与AC患者总体的Eckardt总分、反流频率、体质量下降程度均具有中度相关性（r=0.528、0.441、0.662,P均＜0.05）,与Ⅰ型患者的体质量下降程度具有强相关性（r=0.703,P＜0.05）;食管下括约肌静息压与AC患者总体的体质量下降程度具有弱相关性（r=0.398,P＜0.05）.结论 不同类型AC患者的症状严重程度可能不同,HRM参数尤其是IRP对AC症状严重程度可能具有评估价值.Objective To investigate the correlation between the clinical symptoms of patients with achalasia of cardia （AC） and high-resolution manometry （HRM） parameters.Methods The clinical data of 30 AC patients were retrospectively analyzed.The severe degree of symptoms was evaluated by Eckardt score questionnaires,and motility of esophagus was assessed by HRM parameters.According to Chicago classification,patients were divided into three types.Mann-Whitney U test was performed for non normal distribution quantitative data comparison.Spearman correlation was used to analyze the correlation between AC symptoms and the HRM parameters.Results The reflux symptom of type Ⅱ patients was more severe than that of type Ⅰ patients （2.50（1.00） vs 1.00（1.50）,U=56.000,P＜0.05）.The integrated relaxation pressure （IRP） was moderately correlated with total Eckardt score of all AC patients,the frequency of reflux and the degree of body weight loss （r=0.528,0.441 and 0.662,all P＜0.05）,furthermore IRP was strongly correlated with the degree in weight loss in type Ⅰ AC patients （r =0.703,P＜ 0.05）.Lower esophageal sphincter resting pressure was weakly correlated with the degree of weight loss in all AC patients （r=0.398,P＜0.05）.Conclusions The degree of severity of symptoms may be different in different types of AC patients.HRM parameters,especially IRP,might play a role in the assessment of severity of AC symptoms.

关 键 词：贲门失弛缓症 高分辨率食管测压 测压参数 临床症状 

分 类 号：R571[医药卫生—消化系统]