老年胃食管反流病患者的食管动力及反流特点分析  

Analysis of the characteristics of esophageal motility and reflux in aged patients with gastroesophageal reflux disease

作　　者：王慧芬[1] 张艳丽[1] 王淼[1] 杜时雨[1] WANG Huifen;ZHANG Yanli;WANG Miao;DU Shiyu(Department of Gastroenterology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院消化内科,北京100029

出　　处：《胃肠病学和肝病学杂志》2018年第6期643-646,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析老年胃食管反流病(gastroesophageal reflux disease,GERD)患者的一般人口学特征、食管动力学及反流监测的特点,为临床诊断及治疗提供帮助。方法选取2016年10月至2017年5月在中日友好医院门诊诊断为GERD的80例患者,将其分为老年组(≥60岁)和中青年组(<60岁),分析两组患者的一般人口学特征及食管动力学、反流监测情况。结果老年组的Demeester评分、酸反流次数及立位pH<4.0时间占总监测时间百分比均显著高于中青年组(P<0.05)。老年组的LES静息压、UES静息压、DCI与中青年组相比显著降低(P<0.05)。老年组的食管收缩力度指标中正常收缩占总收缩的比例与中青年组相比也显著降低(P=0.023)。Demeester评分与年龄有直线相关关系,呈正相关,即年龄越大,Demeester评分越高。UES静息压与年龄有直线相关关系,呈负相关,即年龄越大,UES静息压越低。结论与中青年GERD患者相比,老年GERD患者食管抗反流屏障功能减弱,食管体部运动功能减弱,酸暴露程度明显。Objective To investigate the characteristics of general demographic characteristics,esophageal dynamics and reflux monitoring in aged patients with gastroesophageal reflux disease（ GERD）,and to provide help for clinical diagnosis and treatment. Methods Eighty GERD patients from Oct. 2016 to May. 2017 in China-Japan Friendship Hospital were enrolled in the study. These patients were divided into the aged group（ ≥60 years old） and young group（ 60 years old）. The general demographic characteristics,esophageal dynamics and reflux monitoring of two groups were analyzed. Results The Demeester score,acid reflux and percentage of pH 4. 0 time in the aged group were significantly higher than those in the young group（ P 0. 05）. LES resting pressure,UES resting pressure and DCI in the aged group were significantly lower than those in the young group（ P 0. 05）. The proportion of normal contraction to total contraction in the aged group was significantly lower than that in the young group（ P = 0. 023）. There was a positive correlation between Demeester score and age,the older the age,the higher the Demeester score. There was a negative correlation between UES resting pressure and age,the older the age,the lower the resting pressure of UES. Conclusion Compared with young GERD patients,the anti reflux barrier of the aged patients with GERD is weakened,the motility of the esophagus is weakened,and the degree of acid exposure is obvious.

关 键 词：胃食管反流病 高分辨食管测压 食管反流监测 

分 类 号：R571[医药卫生—消化系统]