进行性系统性硬化症患者血清一氧化氮含量和食管动力变化特征的研究  

Study on Serum Concentration of Nitric Oxide and Esophageal Motility Changes in Patients with Progressive Systemic Sclerosis

作　　者：黄颖秋 王昕 刘丽 

机构地区：[1]本溪钢铁(集团)公司总医院消化内科,117000

出　　处：《胃肠病学》2002年第6期345-346,372,共3页Chinese Journal of Gastroenterology

摘　　要：背景:进行性系统性硬化症(PSS)患者多伴有食管动力功能障碍,而一氧化氮(N0)在PSS食管动力异常发病机制中的作用尚不清楚。目的:探讨NO在PSS食管动力异常发病机制中的作用。方法:12例PSS患者和12名健康志愿者纳入本研究。应用硝酸还原酶法测定受试者的血清NO含量;应用PC polygraph HR高分辨多通道测压系统检测食管下括约肌(LES)压力(LESP)、LES长度(LESL)和食管远端蠕动幅度等动力参数;应用Digitrapper MKⅢ动态pH监测仪监测24 h食管内pH等参数。结果:PSS患者的血清NO含量显著高于对照组(106.47μmol/L±18.21μmol/L对82.32μmol/L±15.30μmol/L,P<0.01),LESP显著低于对照组(1.21 kPa±O.11 kPa对2.38 kPa±0.16 kPa,P<0.05),食管远端蠕动幅度亦显著低于对照组(5.18 kPa±1.04 kPa对14.93 kPa±2.12 kPa,P<0.01),75％的PSS患者有一过性LES松弛(TLESR)。PSS患者24 h食管内pH<4的发生频率显著高于对照组。结论:内源性NO可能参与了PSS食管动力异常的发病机制。Background: It is well known that esophageal motor dysfunction occurs in majority of patients with progressive systemic sclerosis (PSS). However, the effect of nitric oxide (NO) in the pathogenesis of esophageal motility changes in patients with PSS is obscure. Aims: To investigate the effect of NO in the pathogenesis of esophageal motor dysfunction in patients with PSS. Methods: 12 patients with PSS and 12 healthy subjects were recruited in this study. The serum concentration of NO was measured with nitrate reductase method. The parameters used including lower esophageal sphincter (LES) pressure (LESP), LES length (LESL), and the distal esophageal peristalsis amplitude, which were determined by PC polygraph HR manometry testing system. 24-hour pH was detected by Digitrapper MK I ambulant monitor. Results: The serum concentration of NO in PSS patients was significantly higher than that in the controls (106.47μmol/L±18.21 μmol/L vs 82.32μmol/L±15.30μmol/L, P<0.01). LESP in patients with PSS was lower than that in the controls (1.21 kPa±0.11 kPa vs 2.38 kPa±0.16 kPa, P<0.05), so was the peristalsis amplitude of distal esophagus (5.18 kPa±1.04 kPa vs 14.93 kPa±2.12 kPa, P<0.01). Transient LES relaxation (TLESR) was seen in 75% of PSS patients. 24-hour pH-metry showed that the frequency of pH<4 increased in PSS patients in comparison with that in the controls. Conclusions: The endogenous NO may play an important role in the pathogenesis of esophageal motor dysfunction in patients with PSS.

关 键 词：进行性系统性硬化症 血清 一氧化氮 食管动力变化 研究 

分 类 号：R593.2[医药卫生—内科学]