无效食管动力的动力学特征及其与反流事件的关系  

Dynamic Characteristics of Ineffective Esophageal Motility and Relationship With Reflux Events

作　　者：王欣欣 董培雯 陈敏[1] 刘丽[1] 林琳 段慧[1] 孙晓滨[1] 王琼[1] WANG Xinxin;DONG Peiwen;CHEN Min;LIU Li;LIN Lin;DUAN Hui;SUN Xiaobin;WANG Qiong(Department of Gastroenterology,the Third People’s Hospital of Chengdu,Chengdu,610031)

机构地区：[1]成都市第三人民医院消化科,610031

出　　处：《胃肠病学》2021年第12期720-723,共4页Chinese Journal of Gastroenterology

基　　金：四川省中医药管理局项目(2021MS155);四川省卫生健康委项目(21PJ143)。

摘　　要：背景:食管动力障碍最常见的类型是无效食管动力(IEM),食管动力在一定程度上可反映酸反流情况,但动力障碍的严重程度与症状之间的关系并不确定。目的:分析IEM患者食管动力学特征与反流事件的关系。方法:选取2020年12月—2021年4月于成都市第三人民医院就诊的具有反酸、烧心等反流症状的32例IEM患者,根据食管远端收缩积分(DCI)分为轻型组和重型组,并行食管高分辨率测压(HRM)、24 h食管pH-阻抗监测和内镜检查。比较IEM患者的临床特征、食管动力学和反流事件,并探讨IEM严重程度与反流事件的关系。结果:与轻型组相比,重型组下食管括约肌(LES)长度、LES静息压(LESP)、4 s完整松弛压无明显差异(P>0.05),DCI显著降低(P<0.05)。轻型IEM组与重型IEM组患者总酸暴露时间(AET)、立位AET、卧位AET相比差异均无统计学意义(P>0.05)。轻型组、重型组AET与DCI、LESP呈负相关(P<0.05);AET与总反流次数呈正相关(P<0.05)。结论:IEM与反流事件之间存在相关性,与严重程度无明显相关性。Background:The most common type of esophageal motility disorder is ineffective esophageal motility(IEM).Esophageal motility can reflect acid reflux to a certain extent,however,the relationship between the severity of esophageal motility disorder and symptoms is uncertain.Aims:To analyze the relationship of esophageal dynamic characteristics with reflux events in patients with IEM.Methods:Thirty-two patients with reflux symptoms such as acid reflux,heartburn were selected from December 2020 to April 2021 at the Third People’s Hospital of Chengdu,and were divided into mild group and severe group according to esophageal distal contractile integral(DCI).Esophageal high-resolution manometry(HRM),24-hour esophageal pH-impedance monitoring and endoscopy were performed.The clinical characteristics,esophageal dynamic characteristics and reflux events were compared,and the relationship between the severity of IEM with reflux events was investigated.Results:No significant differences in length of lower esophageal sphincter(LES),LES resting pressure(LESP),4 seconds integrated relaxation pressure were found between the two groups(P>0.05),and DCI was significantly decreased in severe group than in mild group(P<0.05).No significant differences in esophageal acid exposure time(AET),upright AET and supine AET were found between the two groups(P>0.05).AET was negatively related to DCI,LESP in mild,severe groups(P<0.05);AET was positively related to times of reflux(P<0.05).Conclusions:There is a correlation between IEM and reflux events,but is not correlated with severity.

关 键 词：无效食管动力 反流事件 高分辨率测压 24 h食管pH-阻抗监测 

分 类 号：R571[医药卫生—消化系统]