高分辨率食管测压对胃食管反流病食管运动功能诊断的应用价值  

Application Value of High-resolution Esophageal Manometry for Diagnosis of Esophageal Motor Function in Gastroesophageal Reflux Disease

作　　者：牛涛 叶婷 王玉玉 赵晓红 NIU Tao;YE Ting;WANG Yuyu;ZHAO Xiaohong(School of Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学临床医学院,银川750004

出　　处：《宁夏医科大学学报》2021年第9期939-943,共5页Journal of Ningxia Medical University

摘　　要：目的探讨高分辨率食管测压对于胃食管反流病食管运动功能诊断的应用价值。方法收集宁夏医科大学总医院2015年9月—2019年9月,伴有典型胃食管反流症状并经胃镜、24 h pH测定等相关检查诊断为胃食管反流病的患者共38例,收集无反流症状、胃镜及24 h pH测定未见明显异常的正常对照组共22例,分析比较其高分辨率食管测压相关指标。结果胃食管反流病患者食管下括约肌平均静息压(LESP)、远端收缩积分(DCI)、收缩前沿速度(CFV)与对照组比较差异均有统计学意义(P均<0.05)。GERD患者pH<4的总时间百分比、立位pH<4的时间百分比、卧位pH<4的时间百分比、pH<4的反流次数、最长反流持续时间、反流持续≥5 min次数、Demeester评分与对照组相比差异均有统计学意义(P均<0.05)。GERD患者食管下括约肌长度(LESL)、LESP、DCI、CFV、食团内部压力(IBP)、远端潜伏期(DL)指标中,部分患者存在单项或多项指标异常,总异常率78.95%,三项以上指标异常率39.47%。结论胃食管反流病患者存在食管下括约肌功能及食管体部运动功能异常,食管运动功能异常时高度提示抗反流屏障机制受损而存在病理性反流,高分辨率食管测压可以作为辅助检查用以明确GERD患者是否存在食管运动功能障碍。Objective To explore the value of high-resolution esophageal manometry in the diagnosis of esophageal motor function in gastroesophageal reflux disease. Methods A total of 38 patients with typical gastroesophageal reflux symptoms diagnosed as gastroesophageal reflux disease by gastroscopy and 24 h pH measurement in the General Hospital of Ningxia Medical University from September 2015 to September 2019 were collected. A total of 22 normal controls without reflux symptoms and no obvious abnormalities by gastroscopy and 24 h pH measurement were collected. The relevent indexes of high-resolution esophageal manometry were analyzed and compared. Results The lower esophageal sphincter pressure(LESP),distal contractile integral(DCI)and contractile front velocity(CFV)of patients with gastroesophageal reflux disease were significantly different from those in asymptomatic control group(P all<0.05). The total time percentage of pH<4,the time percentage of standing position pH<4,the time percentage of lying position pH<4,the reflux times of pH<4,the longest reflux duration,the times of reflux ≥ 5 min,and the Demeester score in GERD patients were significantly higher than those in asymptomatic control group(P all<0.05). Among the lower esophageal sphincter length(LESL),LESP,DCI,CFV,introbolus pressure(IBP)and distal latency(DL)indexes in GERD patients,some patients had single or multiple abnormal indexes,the total abnormal rate was 78.95%,and the abnormal rate of more than three indexeswas 39.47%. Conclusion Patients with gastroesophageal reflux disease have abnormal LES function and esophageal body movement function. When the esophageal motor function is abnormal,it is highly suggested that the anti-reflux barrier mechanism is damaged and pathological reflux is present. High-resolution esophageal manometry can be used as an auxiliary test to determine whether patients with GERD symptoms have esophageal motor dysfunction.

关 键 词：胃食管反流病 高分辨率食管测压 24 h pH测定 食管运动功能 

分 类 号：R573[医药卫生—消化系统]