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[胃食管反流病的食管运动功能]

[Esophageal motor function of gastroesophageal reflux disease].

作者信息

Wang Hong, Tian Yuan, Ding Yan

机构信息

Department of Digestion, Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2010 Aug;32(4):465-9. doi: 10.3881/j.issn.1000-503X.2010.04.023.

Abstract

OBJECTIVE

To study the relationship between esophageal motor functional disorder [decreased lower esophageal sphincter pressure (LESP)and ineffective motility (IEM)] and gastroesophageal reflux disease (GERD).

METHODS

Totally 89 patients with GERD were enrolled in this study. All of them underwent 24-hour pH monitoring with dual-channel probe and stationary esophageal manometry. In addition, 77 of these patients underwent upper endoscopy.

RESULTS

IEM and LES, 10 mmHg were common disturbances in patients with GERD (54% and 48%, respectively). The number of the acid reflux events of distal esophagus and prevalence of moderate or severe erosive esophagitis (EE) were significantly higher in patients with low LESP and IEM than patients without low LESP ( P<0.05). The number of the acid reflux events in distal esophagus was significantly correlated with the severity of esophagitis, distal esophagus amplitude, and LESP, while no such correlation was found between IEM and degree of esophageal acid exposure or esophagitis.

CONCLUSIONS

The pathophysiology of GERD is probably multifactorial. Lower LESP or IEM is not a independent pathophysiological factor for GERD. However,one single factor is insufficient to explain all the pathogenic mechanism of GERD.

摘要

目的

研究食管运动功能障碍[食管下括约肌压力(LESP)降低和无效蠕动(IEM)]与胃食管反流病(GERD)之间的关系。

方法

本研究共纳入89例GERD患者。所有患者均采用双通道探头进行24小时pH监测及静态食管测压。此外,其中77例患者接受了上消化道内镜检查。

结果

IEM和LESP<10 mmHg是GERD患者常见的异常情况(分别为54%和48%)。LESP降低和IEM患者远端食管酸反流事件的数量以及中重度糜烂性食管炎(EE)的患病率显著高于LESP未降低的患者(P<0.05)。远端食管酸反流事件的数量与食管炎的严重程度、远端食管振幅和LESP显著相关,而IEM与食管酸暴露程度或食管炎程度之间未发现此类相关性。

结论

GERD的病理生理学可能是多因素的。LESP降低或IEM不是GERD独立的病理生理因素。然而,单一因素不足以解释GERD的所有致病机制。

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