Helman Laura, Biccas Beatriz Nunes, Lemme Eponina M O, Novais Paula, Fittipaldi Viviane
Unidade de Esôfago, Serviço de Gastroenterologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, RJ, Brasil.
Arq Gastroenterol. 2012 Jan-Mar;49(1):64-8. doi: 10.1590/s0004-28032012000100011.
Barrett's esophagus (BE) is characterized by intestinal metaplasia in the distal esophagus and is classified as short-segment (<3 cm - SSBE) or long-segment (>3 cm - LSSBE). It is suggested that LSSBE is associated with more severe esophageal motor abnormalities and increased acid exposure time than SSBE.
To evaluate the prevalence of esophageal manometriy abnormalities and acid exposure times in patients with SSBE and LSSBE.
Barrett's esophagus patients identified by upper endoscopy and confirmed by histopathology were, retrospectively, reviewed and divided into two groups: SSBE and LSBE. Demographic data, symptom duration, prevalence of hiatal hernia, lower esophagus sphincter basal pressure, prevalence of esophageal body abnormalities and acid exposure times were evaluated.
Forty-six patients with SSBE (24 males - 52.2%, mean age of 55.2 years) and 28 patients with LSBE (18 males - 64.3%, mean age of 50.5 years). Mean symptom duration was 9.9 years for SSBE and 12.9 years for LSSBE. Hiatal hernia was present in 84.2% of SSBE, 96.3% of LSBE; average lower esophagus sphincter pressure in SSBE 9.15 mm Hg, in LSBE 6.99 mm Hg; lower esophagus sphincter hypotension in SSBE was 65.9%, in LSSBE 82.1%; aperistalsis in SSBE 6.5%, LSSBE 3.6%; mild/moderate ineffective esophageal motility in SSBE 34.8%, LSBE 46.4%; severe moderate ineffective esophageal motility in SSBE 10.9%, LSBE 7,1%; nutcracker esophagus/segmental nutcracker esophagus in SSBE 8.6%, LSBE 0%; normal body in SSBE 39.1%, in LSBE 42.9%, no statistical difference for any of these values (P<0.05). Average % total time pH<4 in SSBE 9.12, LSBE 17.27 (P<0.000); % time pH<4 upright in SSBE 11.91; LSBE 24.29 (P=0.003); % time pH<4 supine in SSBE 10.86, LSBE 33.26 (P = 0.000).
There was no difference between the prevalence of motor disorders in patients with SSBE and LSSBE. Acid reflux in upright and supine positions was more intense in LSBE.
巴雷特食管（BE）的特征是远端食管出现肠化生，分为短段型（<3 cm - SSBE）或长段型（>3 cm - LSSBE）。有人认为，与SSBE相比，LSSBE与更严重的食管运动异常及更长的酸暴露时间相关。
评估SSBE和LSSBE患者食管测压异常及酸暴露时间的发生率。
回顾性分析经上消化道内镜检查确诊并经组织病理学证实的巴雷特食管患者，将其分为两组：SSBE组和LSBE组。评估人口统计学数据、症状持续时间、食管裂孔疝发生率、食管下括约肌基础压力、食管体部异常发生率及酸暴露时间。
46例SSBE患者（24例男性 - 52.2%，平均年龄55.2岁）和28例LSBE患者（18例男性 - 64.3%，平均年龄50.5岁）。SSBE患者平均症状持续时间为9.9年，LSSBE患者为12.9年。SSBE患者食管裂孔疝发生率为84.2%，LSBE患者为96.3%；SSBE患者食管下括约肌平均压力为9.15 mmHg，LSBE患者为6.99 mmHg；SSBE患者食管下括约肌低压发生率为65.9%，LSSBE患者为82.1%；SSBE患者无蠕动发生率为6.5%，LSSBE患者为3.6%；SSBE患者轻度/中度无效食管动力发生率为34.8%，LSBE患者为46.4%；SSBE患者重度无效食管动力发生率为10.9%，LSBE患者为7.1%；SSBE患者胡桃夹食管/节段性胡桃夹食管发生率为8.6%，LSBE患者为0%；SSBE患者食管体部正常发生率为39.1%，LSBE患者为42.9%，这些数值均无统计学差异（P<0.05）。SSBE患者pH<4的总时间平均百分比为9.12，LSBE患者为17.27（P<0.000）；SSBE患者直立位pH<4的时间百分比为11.91，LSBE患者为24.29（P = 0.003）；SSBE患者仰卧位pH<4的时间百分比为10.86，LSBE患者为33.26（P = 0.000）。
SSBE和LSSBE患者运动障碍的发生率无差异。LSBE患者直立位和仰卧位的酸反流更严重。
