Deprez P, Fiasse R
Department of Internal Medicine, Cliniques Universitaires Saint-Luc, Catholic University of Louvain, Brussels, Belgium.
Dig Dis Sci. 1999 Jan;44(1):125-33. doi: 10.1023/a:1026614519572.
Reflux esophagitis is frequently associated with peristaltic dysfunction, which increases with the severity of inflammatory lesions. In order to assess peristaltic dysfunction with more accuracy before and after healing, we used a 24-hr pH and pressure recording method. Nineteen patients (median age: 65, range: 33-77) with stage II and III (Savary-Miller classification) esophagitis and peristaltic dysfunction were treated with 40 mg omeprazole for three to six months until complete endoscopic healing was achieved. Before treatment, median contraction amplitude was significantly lower than median contraction amplitude of a control group of comparable age [31 (21-53) versus 42 (21-77) mm Hg, P < 0.01], as well as median percentage of peristaltic contractions [27 (16-63) versus 44 (11-56), P < 0.01]. At the end of treatment, a statistically significant improvement of esophageal motor functions was observed for both median contraction amplitude [38 (26-55), P = 0.001] and median percentage of peristaltic waves [45 (23-68), P = 0.0001]. The posttreatment values, although still low, were not significantly different from control values. In conclusion, complete healing of grade II and III esophagitis improves peristalsis. Inflammatory processes related to severe esophagitis may be involved in failed peristalsis and low contraction amplitude.
反流性食管炎常与蠕动功能障碍相关，且随着炎症病变严重程度的增加而加重。为了更准确地评估愈合前后的蠕动功能障碍，我们采用了24小时pH值和压力记录方法。19例II期和III期（Savary-Miller分类）食管炎且伴有蠕动功能障碍的患者（中位年龄：65岁，范围：33 - 77岁）接受了40毫克奥美拉唑治疗三至六个月，直至内镜检查完全愈合。治疗前，中位收缩幅度显著低于年龄相仿的对照组的中位收缩幅度[31（21 - 53）对42（21 - 77）毫米汞柱，P < 0.01]，蠕动收缩的中位百分比也是如此[27（16 - 63）对44（11 - 56），P < 0.01]。治疗结束时，观察到食管运动功能在中位收缩幅度[38（26 - 55），P = 0.001]和蠕动波中位百分比[45（23 - 68），P = 0.0001]方面均有统计学意义的改善。治疗后的数值虽然仍然较低，但与对照值无显著差异。总之，II级和III级食管炎的完全愈合可改善蠕动功能。与严重食管炎相关的炎症过程可能参与了蠕动失败和收缩幅度降低。
