CAJ | 학술논문

目的研究胃食管反流病(GERD)患者伴或不伴食管损伤与食管动力和酸反流之间的相关性.方法对符合GERD诊断标准的25例受试者行胃镜检查,随后进行高分辨率食管测压检查,并检测进食标准试验餐后的动态食管pH值变化.比较伴或不伴食管损伤组患者之间的食管动力和餐后食管酸反流时间的差异.同时按DeMeester评分将受试者分为非酸反流组和酸反流组,比较两组食管动力学指标的变化.统计学处理采用t检验和秩和检验.结果伴或不伴食管损伤组之间下食管括约肌(LES)压力基础值、LES压力残余平均值、食管蠕动传播速度、食管pH＜4的时间和DeMeester评分均差异无统计学意义(P均＞0.05),但是伴食管损伤组的食管收缩幅度明显弱于不伴食管损伤组(31.9 mm Hg比64.2 mm Hg,1 mm Hg=0.133 kPa;Z=-2.37,P=0.02).酸反流组和非酸反流组之间LES压力基础值、LES压力残余平均值、食管蠕动传播速度差异均无统计学意义(P均＞0.05),但酸反流组的食管收缩幅度明显弱于非酸反流组(36.4 mm Hg比71.8mm Hg;Z=2.25,P=0.02).结论 GERD患者LES压力及食管酸反流与食管损伤之间无显著关系,食管蠕动性收缩功能可能与食管损伤及酸反流有关.
목적 연구위식관반류병(GERD)환자반혹불반식관손상여식관동력화산반류지간적상관성.방법 대부합GERD진단표준적25례수시자행위경검사,수후진행고분변솔식관측압검사,병검측진식표준시험찬후적동태식관pH치변화.비교반혹불반식관손상조환자지간적식관동력화찬후식관산반류시간적차이.동시안DeMeester평분장수시자분위비산반류조화산반류조,비교량조식관동역학지표적변화.통계학처리채용t검험화질화검험.결과 반혹불반식관손상조지간하식관괄약기(LES)압력기출치、LES압력잔여평균치、식관연동전파속도、식관pH＜4적시간화DeMeester평분균차이무통계학의의(P균＞0.05),단시반식관손상조적식관수축폭도명현약우불반식관손상조(31.9 mm Hg비64.2 mm Hg,1 mm Hg=0.133 kPa;Z=-2.37,P=0.02).산반류조화비산반류조지간LES압력기출치、LES압력잔여평균치、식관연동전파속도차이균무통계학의의(P균＞0.05),단산반류조적식관수축폭도명현약우비산반류조(36.4 mm Hg비71.8mm Hg;Z=2.25,P=0.02).결론 GERD환자LES압력급식관산반류여식관손상지간무현저관계,식관연동성수축공능가능여식관손상급산반류유관.
Objective To study the relation of esophageal motility and acid reflux between gastroesophageal reflux disease (GERD) patients with and without esophageal injury.Methods A total of 25 patients who met the GERD diagnosis criteria were conducted esophageal-gastric-duodenal endoscopy examination and followed with high-resolution esophageal manometry.The changes of esophageal pH postprandial were also detected.The differences of esophageal motility and acid reflux time between GERD patients with and without esophageal injury were compared.Patients were divided into non-acid reflux group and acid reflux group according to DeMeester score.The changes of esophageal motility indexes of these two groups were compared.Wilcoxon test and t test were used for statistical analysis.Results There was no significant difference in baseline value of lower esophageal sphincter (LES) pressure,remained LES pressure,speed of the esophageal peristalsis,the time of esophageal pH＜4 and DeMeester score between groups with and without esophageal injury (all P＞0.05).But esophageal contraction amplitude of group with esophageal injury was lower than that of group without esophageal injury (31.9 mm Hg vs 64.2 mm Hg,1 mm Hg=0.133 kPa,Z=-2.37,P=0.02).There was no significant difference in baseline value of LES pressure,remained LES pressure,speed of the esophageal peristalsis between acid reflux group and non acid reflux group (all P＞0.05).But the esophageal contraction amplitude of acid reflux group was lower than that of non acid reflux group (36.4 mm Hg vs 71.8 mm Hg,Z=-2.25,P=0.02).Conclusions There was no significant correlation between the LES pressure and esophageal acid reflux with esophageal injury in GERD patients.Esophageal peristalic contraction may be associated with esophageal injury and acid reflux.