Gutschow Christian A, Leers Jessica M, Schröder Wolfgang, Prenzel Klaus L, Fuchs Hans, Bollschweiler Elfriede, Bludau Marc, Hölscher Arnulf H
Department of General, Visceral, and Cancer Surgery, University of Cologne, Germany.
Ger Med Sci. 2011;9:Doc22. doi: 10.3205/000145. Epub 2011 Aug 18.
BACKGROUND/AIMS: The impact of aging on esophageal motility is not completely understood. This study aims at assessing 1) whether degeneration of esophageal body motility occurs with age and 2) whether this development is influenced by gastroesophageal reflux disease (GERD).
326 consecutive patients with symptoms of GERD underwent a diagnostic work-up including a water-perfused esophageal manometry. Patients were divided by age: 17-39 years (group 1, n=75), 40-49 years (group 2, n=79), 50-59 years (group 3, n=64), 60-69 years (group 4, n=74), and >70 years (group 5, n=34). GERD was diagnosed if patients had erosive esophagitis at endoscopy, a positive pH-metry, or both. The amplitude of esophageal contraction waves 3 cm and 8 cm above the lower esophageal sphincter and the percentage of peristaltic contraction waves of the tubular esophagus were analyzed and correlated to GERD.
A normal esophageal manometry was found in 86.7%, 73.4%, 67.2%, 58.1%, and 55.9% (p<0.01) in groups 1-5, respectively. Esophageal contraction wave amplitudes were affected by age in patients positive for GERD only (p<0.01). Esophageal body peristalsis was affected by age (p<0.01) independent of the diagnosis of GERD.
Aging is correlated to esophageal motor abnormalities. GERD has a significant impact on esophageal contraction wave amplitude, but not on peristalsis.
背景/目的：衰老对食管动力的影响尚未完全明确。本研究旨在评估：1）食管体部动力是否会随着年龄增长而退化；2）这种变化是否受胃食管反流病（GERD）影响。
326例有GERD症状的连续患者接受了包括水灌注食管测压在内的诊断性检查。患者按年龄分组：17 - 39岁（第1组，n = 75），40 - 49岁（第2组，n = 79），50 - 59岁（第3组，n = 64），60 - 69岁（第4组，n = 74），以及＞70岁（第5组，n = 34）。若患者在内镜检查中发现糜烂性食管炎、pH值测定呈阳性或两者均有，则诊断为GERD。分析食管下括约肌上方3 cm和8 cm处食管收缩波的幅度以及管状食管蠕动收缩波的百分比，并与GERD进行相关性分析。
第1 - 5组中食管测压正常的比例分别为86.7%、73.4%、67.2%、58.1%和55.9%（p < 0.01）。仅GERD阳性患者的食管收缩波幅度受年龄影响（p < 0.01）。食管体部蠕动受年龄影响（p < 0.01），且与GERD诊断无关。
衰老与食管运动异常相关。GERD对食管收缩波幅度有显著影响，但对蠕动无影响。
