Corsi Paulo Roberto, Gagliardi Danilo, Horn Mozar, Pochini Celso de Castro, Oliveira Neto Reinaldo Martins de
Grupo de Afecções do Esôfago, Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, SP.
Rev Assoc Med Bras (1992). 2007 Mar-Apr;53(2):152-7. doi: 10.1590/s0104-42302007000200021.
To analyze clinical, abdominal ultrasound, upper digestive endoscopic, esophageal manometric and prolonged esophageal pH-monitoring findings in patients with typical symptoms of GERD.
The study included a total of 251 patients with typical GERD symptoms. Clinical data, Body Mass Index, abdominal ultrasound aspects and upper digestive endoscopic data are reported. Manometry and esophageal pH-monitoring were performed.
One-hundred-and-seventy-two patients were female (68.5%). Mean age of the total was 51.8 years. Ultrasound examination revealed colelithiasis in 23 patients and PC in 21 patients. Hiatal hernia was diagnosed in 177 patients (71%), with an average size of 3.0 cm. Erosive esophagitis was found in 168 patients (66.9%) and Barrett's esophagus in 23 patients (9.2%). A combination of hiatal hernia and esophagitis was diagnosed in 131 patients (52.3%) while only 37 patients (14.7%) did not present either. The mean extension of the lower esophageal sphincter (LES) was 2.6 cm, whereas in 132 patients (52.6%) the LES was shorter. The mean pressure of the LES was 18.9 mmHg; 46 patients (18.3%) had pressures below 14 mmHg. The mean number of reflux episodes on prolonged esophageal monitoring was 42.9; the mean number of prolonged episodes of reflux was 4.6, and the mean percentage of total acid time was 8.4%. DeMeester scores were high in 175 patients (69.7%).
In patients with typical GERD symptoms, factors influencing the presence of pathological reflux as confirmed by prolonged esophageal pH-monitoring were: age, hiatal hernia associated to erosive esophagitis, a smaller extension, low baseline pressure and smaller volume vector of the LES.
分析胃食管反流病（GERD）典型症状患者的临床、腹部超声、上消化道内镜、食管测压及食管pH值长时间监测结果。
本研究共纳入251例有GERD典型症状的患者。报告了临床资料、体重指数、腹部超声表现及上消化道内镜检查数据。进行了测压和食管pH值监测。
172例患者为女性（68.5%）。总体平均年龄为51.8岁。超声检查发现23例患者有胆结石，21例患者有胰腺病变。177例患者（71%）诊断为食管裂孔疝，平均大小为3.0 cm。168例患者（66.9%）发现糜烂性食管炎，23例患者（9.2%）发现巴雷特食管。131例患者（52.3%）诊断为食管裂孔疝合并食管炎，而仅有37例患者（14.7%）未出现上述任何一种情况。食管下括约肌（LES）平均长度为2.6 cm，132例患者（52.6%）的LES较短。LES平均压力为18.9 mmHg；46例患者（18.3%）的压力低于14 mmHg。食管长时间监测时反流发作的平均次数为42.9次；反流长时间发作的平均次数为4.6次，总酸暴露时间的平均百分比为8.4%。175例患者（69.7%）的DeMeester评分较高。
在有GERD典型症状的患者中，经食管pH值长时间监测证实影响病理性反流存在的因素有：年龄、与糜烂性食管炎相关的食管裂孔疝、较短的长度、较低的基础压力及较小的LES容量向量。
