【摘要】 目的 :分析酒精性肝硬化患者肝功能减退对食管动力及血浆胃动素的影响。方法 :酒精性肝硬化患者 4 4例和健康对照组 30例 ,通过PCPolygrafHR检测食管运动功能 ,应用放免法检测空腹血浆MTL。结果 :与对照组比较 ,肝硬化患者下食管括约肌压力 (LESP)及食管远端蠕动波幅 (PA)、蠕动持续时间 (PD)、蠕动传导速度 (PV)均明显异常 (P <0 .0 1)。肝硬化从A级B级到C级远端的PA、PD、PV异常进行性加重 ,LESP显著下降。食管近端的PA、PD、PV在肝硬化患者及对照组间无显著差异(P >0 .0 5 ) ,在肝硬化Child -Pugh三级分级之间也无显著差异 (P >0 .0 5 )。LESP与肝功能Child -Pugh分数呈显著负相关 ,γ= - 0 .76 4 ,(P <0 .0 1)。与对照组相比 ,肝硬化患者血浆MTL浓度明显升高 (P <0 .0 1) ,在肝硬化Child -Pugh三级分级之间也有显著差异 (P <0 .0 1) ,MTL与肝功能Child -Pugh分数呈显著正相关 ,(γ =0 .981,P <0 .0 1)。结论 :肝硬化患者有食管远端的动力异常及LESP下降 ,这改变与肝功能减退有关。血浆MTL水平对判断肝硬化病情有一定的意义更多还原

【Abstract】 Objective: To study changes of esophageal motility and plasma motilin(MTL) in alcoholic liver cirrhosis. Methods: Esophageal motility was determined by PC Polygraf HR system and plasma motilin by RIA in 44 cases of alcoholic liver cirrhosis and 30 cases of normol control. Results: Pressure of lower esophageal sphincter(LESP) and peristaltic amplitude(PA), peristaltic duration(PD), peristaltic velocity(PV) of liver cirrhosis in distal esophagus showed significantly difference in comparison with those in control group (P<0.01), and there was significantly negative correlation between LESP and Child-Pugh score (γ = - 0.764, P<0.01). PA, PD, PV of liver cirrhosis in proximal esophagus showed no difference in comparison with those in control group (P>0.05). Plasma concentration of MTL in liver cirrhosis was higher than that in control (P< 0.01), and was positively correlated with Child-Pugh score (γ=0.981,P<0.01). Conclusion:The changes of esophageal motility in alcoholic liver cirrhosis were mainly expressed in dysfunction of distal esophagus and lower LESP. The progress of hepatic dysfunction reduced LESP, and deteriorated esophageal motility. Plasma concentration of MTL may be helpful in understanding severity of liver cirrhosis.更多还原