Department of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing, China (mainland).
Med Sci Monit. 2021 Feb 19;27:e928554. doi: 10.12659/MSM.928554.
BACKGROUND The multiple rapid swallows (MRS) test is used to assess esophageal contraction reserve. In this study, we characterized the expression of the MRS test in patients with reflux burden and other symptomatic phenotypes with refractory gastroesophageal reflux disease (rGERD). MATERIAL AND METHODS Patients with rGERD who underwent high-resolution manometry (HRM) and esophageal pH-impedance monitoring (EIM) between September 2018 and January 2020 were retrospectively studied. RESULTS We enrolled 151 patients and divided them into 4 phenotypes according to the results of EIM. In phenotype 1, the MRS distal contractile integral (DCI) was significantly positively correlated with acid-liquid reflux episodes. In phenotype 2, lower esophageal sphincter pressure (LES) length was significantly positively correlated with MRS DCI, and MRS/single-swallow (SS) DCI ratio. In phenotype 3, MRS DCI was negatively correlated with the DeMeester score, acid exposure time (AET), upright AET, long-term acid reflux episodes, acid-mixed reflux episodes, recumbent acid reflux episodes, and total acid reflux episodes. There was a significant negative correlation between MRS/SS DCI and recumbent acid reflux episodes. In phenotype 4, nonacid-liquid episodes and recumbent nonacid reflux episodes were significantly higher in the abnormal MRS group. However, acid-gas episodes, weakly acid-gas episodes, and upright gas reflux episodes were higher in the normal MRS group than in the abnormal MRS group. CONCLUSIONS Esophageal contraction reserve is heterogeneous within the reflux burden and symptomatic phenotypes of patients with rGERD.
多次快速吞咽（MRS）测试用于评估食管收缩储备。在这项研究中，我们对反流负担和其他有症状的表型以及难治性胃食管反流病（rGERD）患者的 MRS 测试表现进行了特征描述。
回顾性研究了 2018 年 9 月至 2020 年 1 月期间接受高分辨率测压（HRM）和食管 pH 阻抗监测（EIM）的 rGERD 患者。
我们共纳入 151 例患者，并根据 EIM 结果将其分为 4 种表型。在表型 1 中，MRS 远端收缩积分（DCI）与酸液反流事件呈显著正相关。在表型 2 中，食管下括约肌（LES）长度与 MRS DCI 以及 MRS/单次吞咽（SS）DCI 比值呈显著正相关。在表型 3 中，MRS DCI 与 DeMeester 评分、酸暴露时间（AET）、直立 AET、长期酸反流事件、酸混合反流事件、卧位酸反流事件和总酸反流事件呈负相关。MRS/SS DCI 与卧位酸反流事件呈显著负相关。在表型 4 中，异常 MRS 组的非酸液事件和卧位非酸反流事件显著更高。然而，正常 MRS 组的酸-气体事件、弱酸性气体事件和直立气体反流事件均高于异常 MRS 组。
在 rGERD 患者的反流负担和症状表型中，食管收缩储备存在异质性。
