南昌大学学报(医学版)
南昌大學學報(醫學版)
남창대학학보(의학판)
Acta Academiae Medicinae Jiangxi
2015年
4期
33-35,39
,共4页
胃食管反流病%食管动力障碍%下食管括约肌压力%无效食管运动
胃食管反流病%食管動力障礙%下食管括約肌壓力%無效食管運動
위식관반류병%식관동력장애%하식관괄약기압력%무효식관운동
gastro-esophageal reflux disease%esophageal motility disorder%lower esophageal sphincter pressure%invalid esophageal movement
目的:通过分析下食管括约肌压力(LESP)下降和无效食管运动(IEM)的发生率及其与食管远端 pH<4的>5 min 反流次数、食管酸清除(EAC)时间的关系,探讨 LESP 低下及 IEM 在胃食管反流病(GERD)中的作用。方法将272例 GERD 患者根据标准食管压力测定的结果分为3组:正常组(57例)、LESP 降低组(73例)和 IEM组(142例)。3组患者均行食管测压、24 h 食管动态 pH 检查。观察3组患者食管远端 pH<4的总时间百分比和立位、卧位食管远端 pH<4的时间百分比、食管远端 pH<4的>5 min 反流次数及 EAC 时间(总 EAC 时间和立、卧位 EAC 时间)。结果正常组、LESP 降低组患者食管远端 pH<4的总时间百分比、立位食管远端 pH<4的时间百分比均明显低于 IEM 组,LESP 降低组、IEM 组患者卧位食管远端 pH<4的时间百分比则均明显高于正常组(均 P <0.01);IEM 组患者立位 EAC 时间明显高于正常组,食管远端 pH<4的>5 min 反流次数则明显高于正常组和 LESP 降低组(P <0.05或 P <0.01)。结论由 IEM 和 LESP 降低所引起的食管动力异常是 GERD 的主要诱因,其中前者尤为重要。
目的:通過分析下食管括約肌壓力(LESP)下降和無效食管運動(IEM)的髮生率及其與食管遠耑 pH<4的>5 min 反流次數、食管痠清除(EAC)時間的關繫,探討 LESP 低下及 IEM 在胃食管反流病(GERD)中的作用。方法將272例 GERD 患者根據標準食管壓力測定的結果分為3組:正常組(57例)、LESP 降低組(73例)和 IEM組(142例)。3組患者均行食管測壓、24 h 食管動態 pH 檢查。觀察3組患者食管遠耑 pH<4的總時間百分比和立位、臥位食管遠耑 pH<4的時間百分比、食管遠耑 pH<4的>5 min 反流次數及 EAC 時間(總 EAC 時間和立、臥位 EAC 時間)。結果正常組、LESP 降低組患者食管遠耑 pH<4的總時間百分比、立位食管遠耑 pH<4的時間百分比均明顯低于 IEM 組,LESP 降低組、IEM 組患者臥位食管遠耑 pH<4的時間百分比則均明顯高于正常組(均 P <0.01);IEM 組患者立位 EAC 時間明顯高于正常組,食管遠耑 pH<4的>5 min 反流次數則明顯高于正常組和 LESP 降低組(P <0.05或 P <0.01)。結論由 IEM 和 LESP 降低所引起的食管動力異常是 GERD 的主要誘因,其中前者尤為重要。
목적:통과분석하식관괄약기압력(LESP)하강화무효식관운동(IEM)적발생솔급기여식관원단 pH<4적>5 min 반류차수、식관산청제(EAC)시간적관계,탐토 LESP 저하급 IEM 재위식관반류병(GERD)중적작용。방법장272례 GERD 환자근거표준식관압력측정적결과분위3조:정상조(57례)、LESP 강저조(73례)화 IEM조(142례)。3조환자균행식관측압、24 h 식관동태 pH 검사。관찰3조환자식관원단 pH<4적총시간백분비화립위、와위식관원단 pH<4적시간백분비、식관원단 pH<4적>5 min 반류차수급 EAC 시간(총 EAC 시간화립、와위 EAC 시간)。결과정상조、LESP 강저조환자식관원단 pH<4적총시간백분비、립위식관원단 pH<4적시간백분비균명현저우 IEM 조,LESP 강저조、IEM 조환자와위식관원단 pH<4적시간백분비칙균명현고우정상조(균 P <0.01);IEM 조환자립위 EAC 시간명현고우정상조,식관원단 pH<4적>5 min 반류차수칙명현고우정상조화 LESP 강저조(P <0.05혹 P <0.01)。결론유 IEM 화 LESP 강저소인기적식관동력이상시 GERD 적주요유인,기중전자우위중요。
ABSTRACT:Objective To evaluate the roles of decreased lower esophageal sphincter pressure (LESP)and invalid esophageal movement (IEM)in gastro-esophageal reflux disease (GERD) through analyzing the incidences of low LESP and IEM and their relationships to number of distal esophageal reflux episodes with pH<4 that lasted longer than 5 min and esophageal acid clear-ance(EAC)time.Methods According to the results of standard esophageal pressure measure-ment,272 GERD patients were divided into three groups:normal group (57 cases),low LESP group(73 cases),and IEM group(142 cases).All patients underwent esophageal pressure meas-urement and 24-h dynamic esophageal pH monitoring.The percentage of time of pH<4 in the dis-tal esophagus(upright,supine and total),number of distal esophageal reflux episodes with pH<4 that lasted longer than 5 min,and EAC time(upright,supine and total)were observed in all the three groups.Results Compared with IEM group,percentages of total and upright time of pH<4 in the distal esophagus and number of distal esophageal reflux episodes with pH<4 that lasted longer than 5 min were decreased in normal group and low LESP group,and upright EAC time was shortened in normal group(P <0.05 or P <0.01).Compared with normal group,percentage of supine time of pH<4 in the distal esophagus was increased in low LESP group and IEM group (P <0.01).Conclusion Esophageal motor abnormalities induced by IEM and low LESP,espe-cially IEM,are the main causes of GERD.