Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
World J Gastroenterol. 2011 Apr 7;17(13):1753-8. doi: 10.3748/wjg.v17.i13.1753.
To evaluate the esophageal motility and abnormal acid and bile reflux incidence in cirrhotic patients without esophageal varices (EV).
Seventy-eight patients with liver cirrhosis without EV confirmed by upper gastroesophageal endoscopy and 30 healthy control volunteers were prospectively enrolled in this study. All the patients were evaluated using a modified protocol including Child-Pugh score, upper gastrointestinal endoscopy, esophageal manometry, simultaneous ambulatory 24-h esophageal pH and bilirubin monitoring. All the patients and volunteers accepted the manometric study.
In the liver cirrhosis group, lower esophageal sphincter pressure (LESP, 15.32 ± 2.91 mmHg), peristaltic amplitude (PA, 61.41 ± 10.52 mmHg), peristaltic duration (PD, 5.32 ± 1.22 s), and peristaltic velocity (PV, 5.22 ± 1.11 cm/s) were all significantly abnormal in comparison with those in the control group (P < 0.05), and LESP was negatively correlated with Child-Pugh score. The incidence of reflux esophagitis (RE) and pathologic reflux was 37.18% and 55.13%, respectively (vs. control, P < 0.05). And the incidence of isolated abnormal acid reflux, bile reflux and mixed reflux was 12.82%, 14.10% and 28.21% in patients with liver cirrhosis without EV.
Cirrhotic patients without EV presented esophageal motor disorders and mixed acid and bile reflux was the main pattern; the cirrhosis itself was an important causative factor.
评估无食管静脉曲张（EV）的肝硬化患者的食管动力和异常酸及胆汁反流发生率。
前瞻性纳入 78 例经上消化道内镜检查证实无 EV 的肝硬化患者和 30 名健康对照志愿者。所有患者均采用改良方案进行评估，包括 Child-Pugh 评分、上消化道内镜检查、食管测压、24 小时食管 pH 和胆红素同步动态监测。所有患者和志愿者均接受了测压研究。
在肝硬化组中，食管下括约肌压力（LESP，15.32 ± 2.91mmHg）、蠕动波幅度（PA，61.41 ± 10.52mmHg）、蠕动波持续时间（PD，5.32 ± 1.22s）和蠕动波速度（PV，5.22 ± 1.11cm/s）均显著低于对照组（P<0.05），且 LESP 与 Child-Pugh 评分呈负相关。反流性食管炎（RE）和病理性反流的发生率分别为 37.18%和 55.13%（与对照组相比，P<0.05）。无 EV 的肝硬化患者中孤立性异常酸反流、胆汁反流和混合反流的发生率分别为 12.82%、14.10%和 28.21%。
无 EV 的肝硬化患者存在食管运动障碍，混合性酸和胆汁反流是主要反流模式；肝硬化本身是一个重要的致病因素。
