中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2015年
5期
305-308
,共4页
刘贝妮%张艳丽%姚树坤%杜时雨%刘杨%杨怡
劉貝妮%張豔麗%姚樹坤%杜時雨%劉楊%楊怡
류패니%장염려%요수곤%두시우%류양%양이
非糜烂性反流病%酸暴露%阻抗基线%细胞外隙%黏膜完整性
非糜爛性反流病%痠暴露%阻抗基線%細胞外隙%黏膜完整性
비미란성반류병%산폭로%조항기선%세포외극%점막완정성
Non-erosive reflux disease%Acid exposure%Impedance baseline%Extracellular space%Mucosal integrity
目的 了解非糜烂性反流病(NERD)患者酸诱导的食管阻抗动态变化及其与食管上皮细胞间隙增宽之间的关系.方法 选取2013年9月至2014年7月NERD患者35例和健康对照者20名,行24 h食管多通道腔内阻抗-pH(MII-pH)监测、酸灌注试验和胃镜检查.胃镜下在齿状线上2 cm处的前、后壁各取一块黏膜组织,HE染色后用软件测量食管上皮细胞间隙.统计学处理采用t检验,相关性分析采用Pearson相关分析.结果 NERD患者食管远端阻抗基线和阻抗恢复速率显著低于健康对照组,分别为(2 998±701)Ω比(3 880±1 054)Ω、(30.1±14.0) Ω/min比(53.0±14.5)Ω/min,差异有统计学意义(t=3.65、5.41,P均＜0.01);食管上皮细胞间隙较健康对照组显著增宽,为(1.03±0.20) μm比(0.66±0.14) μm,差异有统计学意义(t=6.57,P＜0.01).酸灌注试验阳性的患者食管阻抗基线和阻抗恢复速率显著低于酸灌注试验阴性的患者,分别为(2 755±680)Ω比(3 411±536)Ω、(25.4±13.0)Ω/min比(33.4±9.8)Ω/min,差异有统计学意义(t=2.99、2.03,P均＜0.05).阻抗恢复速率与上皮细胞间隙呈负相关(r=-0.70,P＜0.01).结论 反复的反流损伤和黏膜修复减慢可能是NERD患者食管黏膜完整性受损的原因.食管阻抗基线的变化在一定程度上可反映食管黏膜完整性受损的程度.
目的 瞭解非糜爛性反流病(NERD)患者痠誘導的食管阻抗動態變化及其與食管上皮細胞間隙增寬之間的關繫.方法 選取2013年9月至2014年7月NERD患者35例和健康對照者20名,行24 h食管多通道腔內阻抗-pH(MII-pH)鑑測、痠灌註試驗和胃鏡檢查.胃鏡下在齒狀線上2 cm處的前、後壁各取一塊黏膜組織,HE染色後用軟件測量食管上皮細胞間隙.統計學處理採用t檢驗,相關性分析採用Pearson相關分析.結果 NERD患者食管遠耑阻抗基線和阻抗恢複速率顯著低于健康對照組,分彆為(2 998±701)Ω比(3 880±1 054)Ω、(30.1±14.0) Ω/min比(53.0±14.5)Ω/min,差異有統計學意義(t=3.65、5.41,P均＜0.01);食管上皮細胞間隙較健康對照組顯著增寬,為(1.03±0.20) μm比(0.66±0.14) μm,差異有統計學意義(t=6.57,P＜0.01).痠灌註試驗暘性的患者食管阻抗基線和阻抗恢複速率顯著低于痠灌註試驗陰性的患者,分彆為(2 755±680)Ω比(3 411±536)Ω、(25.4±13.0)Ω/min比(33.4±9.8)Ω/min,差異有統計學意義(t=2.99、2.03,P均＜0.05).阻抗恢複速率與上皮細胞間隙呈負相關(r=-0.70,P＜0.01).結論 反複的反流損傷和黏膜脩複減慢可能是NERD患者食管黏膜完整性受損的原因.食管阻抗基線的變化在一定程度上可反映食管黏膜完整性受損的程度.
목적 료해비미란성반류병(NERD)환자산유도적식관조항동태변화급기여식관상피세포간극증관지간적관계.방법 선취2013년9월지2014년7월NERD환자35례화건강대조자20명,행24 h식관다통도강내조항-pH(MII-pH)감측、산관주시험화위경검사.위경하재치상선상2 cm처적전、후벽각취일괴점막조직,HE염색후용연건측량식관상피세포간극.통계학처리채용t검험,상관성분석채용Pearson상관분석.결과 NERD환자식관원단조항기선화조항회복속솔현저저우건강대조조,분별위(2 998±701)Ω비(3 880±1 054)Ω、(30.1±14.0) Ω/min비(53.0±14.5)Ω/min,차이유통계학의의(t=3.65、5.41,P균＜0.01);식관상피세포간극교건강대조조현저증관,위(1.03±0.20) μm비(0.66±0.14) μm,차이유통계학의의(t=6.57,P＜0.01).산관주시험양성적환자식관조항기선화조항회복속솔현저저우산관주시험음성적환자,분별위(2 755±680)Ω비(3 411±536)Ω、(25.4±13.0)Ω/min비(33.4±9.8)Ω/min,차이유통계학의의(t=2.99、2.03,P균＜0.05).조항회복속솔여상피세포간극정부상관(r=-0.70,P＜0.01).결론 반복적반류손상화점막수복감만가능시NERD환자식관점막완정성수손적원인.식관조항기선적변화재일정정도상가반영식관점막완정성수손적정도.
Objective To investigate the correlation between dynamic changes in esophageal impedance and dilated intercellular space (DIS) of patients with acid-induced non erosive reflux disease (NERD).Methods From September 2013 to July 2014,a total of 35 patients with NERD and 20 healthy controls were selected and underwent 24 h multichannel intraluminal impedance and pH monitoring (MII-pH monitoring),acid perfusion test and gastroendoscopy examination.One piece of mucosa tissue was taken under gastroendoscope from the anterior and posterior walls at 2 cm above the dentate line of the esophagus.Intercellular space (ICS) of the esophageal epithelia cells was measured by software after hematoxylin and eosin staining.t test and variance analysis were performed for statistical analysis.Pearson correlation analysis was used for correlation analysis.Results Impedance baseline of distal esophagus and impedance recovery rate of patients with NERD were lower than those of healthy control group,which were (2 998±701) Ω vs (3 880±1 054) Ω and (30.1±14.0) Ω/min vs (53.0±14.5) Ω/min,and the differences were statistically significant (t=3.65,5.41;both P＜0.01).Compared with healthy control group,ICS of the esophageal epithelial cells was obviously wider (1.03 ± 0.20) μm vs (0.66±0.14) μm,and the difference was statistically significant (t=-6.57,P＜0.01).Impedance baseline of esophagus and impedance recovery rate of patients with positive acid perfusion test were lower than those of patients with negative acid perfusion test,which were (2 755±680) Ωvs (3 411±536) Ω and (25.4±13.0) Ω minvs (33.4±9.8) Ω /min,and the differences were statistically significant (t =2.99,2.03;both P＜0.05).The correlation between impedance recovery rate and ICS was negative (r=-0.70,P＜0.01).Conclusions Recurrent reflux induced injury and delayed mucosal headline may be the factors of impaired mucosal integrity in patients with NERD.The changes esophageal of impedance baseline to a certain extent reflected the degree of esophageal mucosal integrity impairment.
