Timmer R, Breumelhof R, Nadorp J H, Smout A J
Department of Gastroenterology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Dig Dis Sci. 1994 Oct;39(10):2084-9. doi: 10.1007/BF02090354.
Using conventional manometry and 24-hr ambulatory pressure and pH monitoring, we investigated esophageal motility and the esophageal motor response to reflux in 11 patients with reflux esophagitis Savary-Miller grade III and IV, and an age- and sex-matched group of 11 healthy controls. The patients had a significantly increased esophageal acid exposure. Conventional manometry showed a significantly decreased LES pressure and distal peristaltic amplitude in patients. The 24-hr monitoring yielded a significant decrease in peristaltic contraction duration and peristaltic propagation velocity in the patient group. Distal peristaltic amplitude was not decreased. Analysis of the contractions occurring in the 2-min period after each reflux episode showed a reduced number of contractions during the upright period, caused by a significantly decreased number of peristaltic contractions. During the supine period, there was a trend towards an increased number of contractions. It is concluded that esophageal motor activity and the response to reflux are impaired in patients with high-grade reflux esophagitis. However, the abnormalities found are only minor and are unlikely to play an important role in the pathogenesis of reflux esophagitis.
我们使用传统测压法以及24小时动态压力和pH监测，对11例Savary-Miller III级和IV级反流性食管炎患者以及11名年龄和性别匹配的健康对照者的食管动力和食管对反流的运动反应进行了研究。患者的食管酸暴露显著增加。传统测压显示患者的LES压力和远端蠕动幅度显著降低。24小时监测显示患者组的蠕动收缩持续时间和蠕动传播速度显著降低。远端蠕动幅度未降低。对每次反流发作后2分钟内发生的收缩进行分析显示，直立期收缩次数减少，这是由于蠕动收缩次数显著减少所致。在仰卧期，收缩次数有增加的趋势。结论是，重度反流性食管炎患者的食管运动活性和对反流的反应受损。然而，所发现的异常仅为轻度，不太可能在反流性食管炎的发病机制中起重要作用。
