CAJ | 학술논문

目的：探讨贲门失弛缓症（AC）患者的食管动力学特点及与临床表现的相关性。方法2010年7月至2014年7月104例确诊 AC 患者纳入研究，采用高分辨食管测压（HRM）技术分析食管动力学特点，使用 Eckardt 量表、MDADI 问卷和 SF-36问卷进行症状和生活质量调查，并行相关统计学分析。结果104例均有吞咽困难症状，其中伴反酸37例（35．6％）、烧心28例（26．9％）、体质量下降18例（17．3％），根据 HRM 检测结果采用芝加哥分类诊断标准诊断Ⅰ型 AC 17例（占16．35％）、Ⅱ型 AC 80例（占76．92％）、Ⅲ型 AC 7例（占6．73％）。完成 Eckardt 量表、MDADI 和SF-36问卷调查者分别有29例、20例和25例，结合各自完成问卷调查者的卧位生理盐水吞咽试验HRM检测结果，统计分析发现 Eckardt 量表总评分与 HRM中的整合松弛压（IRP）值呈显著正相关（r ＝0．421，P ＜0．05），MDADI 问卷中的机能影响评分与 HRM 中的 IRP 值呈显著负相关（r ＝－0．530，P ＜0．05）。结论AC 患者以吞咽困难为主要症状，芝加哥分类诊断标准下以Ⅱ型多见。IRP 值可预测 AC 患者临床症状严重程度，并可预测生活质量尤其是生理机能方面的受影响程度。
목적：탐토분문실이완증（AC）환자적식관동역학특점급여림상표현적상관성。방법2010년7월지2014년7월104례학진 AC 환자납입연구，채용고분변식관측압（HRM）기술분석식관동역학특점，사용 Eckardt 량표、MDADI 문권화 SF-36문권진행증상화생활질량조사，병행상관통계학분석。결과104례균유탄인곤난증상，기중반반산37례（35．6％）、소심28례（26．9％）、체질량하강18례（17．3％），근거 HRM 검측결과채용지가가분류진단표준진단Ⅰ형 AC 17례（점16．35％）、Ⅱ형 AC 80례（점76．92％）、Ⅲ형 AC 7례（점6．73％）。완성 Eckardt 량표、MDADI 화SF-36문권조사자분별유29례、20례화25례，결합각자완성문권조사자적와위생리염수탄인시험HRM검측결과，통계분석발현 Eckardt 량표총평분여 HRM중적정합송이압（IRP）치정현저정상관（r ＝0．421，P ＜0．05），MDADI 문권중적궤능영향평분여 HRM 중적 IRP 치정현저부상관（r ＝－0．530，P ＜0．05）。결론AC 환자이탄인곤난위주요증상，지가가분류진단표준하이Ⅱ형다견。IRP 치가예측 AC 환자림상증상엄중정도，병가예측생활질량우기시생리궤능방면적수영향정도。
Objective To evaluate the clinical and manometric characteristics of achalasia.Meth-ods Patients diagnosed as having achalasia from July 2010 to July 2014 at our hospital were enrolled.High resolution manometry(HRM)results were analyzed.Data of Eckardt scale,MDADI and SF-36 were ana-lyzed.Results All subjects had dysphagia,35.6% (37 /104)accompanied with regurgitation,26.9%(28 /104)with heartburn and 17.3%(18 /104)with weight loss.According to HRM results and Chicago classification criteria,16.35%(17 /104)of the subjects were classified as type Ⅰ,76.92%(80 /104)as type Ⅱ and 6.73%(7 /104)as type Ⅲ.27.9%(29 /104),19.2%(20 /104)and 24.0%(25 /104)of the subjects finished Eckardt scale,MDADI and SF-36,respectively.Eckardt score was positively correlated with integrated relaxation pressure(IRP)(r =0.421,P <0.05)and MDADI physical score was negatively with IRP(r =-0.530,P <0.05).Conclusion Dysphagia often occurs as the chief complaint among acha-lasia patients.And type Ⅱ is the most common.IRP is an indicator of the severity of clinical symptoms and impairment of quality of life.