【摘要】 目的 研究胃食管反流病(GERD)与功能性胃灼热(FH)的食管动力差异,为临床治疗提供参考依据。方法 90例消化内科患者,根据疾病类型分为胃食管反流病组和功能性胃灼热组,各45例。两组患者均接受Ⅳ型超敏反应实验诊断和专科检查、综合内镜检查及食管高分辨率测压(HRM)、24 h食管多通道腔内阻抗pH监测。比较两组患者食管裂孔疝发生情况及食管动力参数[食管收缩波波幅、食管体部湿咽有效蠕动比例及食管下括约肌(LES)静息压、食管下括约肌远端收缩积分、食管下括约肌长度]。结果 胃食管反流病组食管裂孔疝发生率40.00%、食管体部湿咽有效蠕动比例(63.93±2.89)%、食管收缩波波幅(51.53±2.41)mm Hg(1 mm Hg=0.133 kPa)、食管下括约肌静息压(20.12±0.83)mm Hg、食管下括约肌远端收缩积分(1293.50±53.14)[mm Hg/(cm·s)]高于功能性胃灼热组的17.78%、(57.18±3.48)%、(44.93±1.87)mm Hg、(17.32±0.45)mm Hg、(1076.12±51.32)[mm Hg/(cm·s)],食管下括约肌长度(3.45±0.13)cm长于功能性胃灼热组的(2.98±0.17)cm,差异具有统计学意义(P<0.05)。结论 胃食管反流病与功能性胃灼热的食管动力存在显著差异,后者更易发生食管动力障碍。更多还原

【Abstract】 Objective To study the difference in esophageal motility between gastroesophageal reflux disease(GERD) and functional heartburn(FH), and to provide reference for clinical treatment. Methods 90 patients in the department of gastroenterology were divided into a gastroesophageal reflux disease group(GERD group) and a functional heartburn group(FH group) according to the type of disease, with 45 patients in each group. Patients of both groups received experimental diagnosis of type Ⅳ hypersensitivity, specialist examination, comprehensive endoscopy, high-resolution manometry(HRM), esophageal multichannel intraluminal impedance and pH monitoring. The incidence of esophageal hiatal hernia and esophageal motility parameters [(esophageal contraction wave amplitude, effective peristalsis ratio of wet pharynx in esophageal body, resting pressure of lower esophageal sphincter(LES), distal contraction integral of lower esophageal sphincter, and length of lower esophageal sphincter] were compared between the two groups. Results In the gastroesophageal reflux disease group, the incidence of hiatal hernia was 40.00%, the effective peristalsis ratio of wet pharynx in esophageal body was(63.93±2.89)%, the amplitude of esophageal contraction wave was(51.53±2.41) mm Hg(1 mm Hg=0.133 kPa), the resting pressure of esophageal sphincter muscle was(20.12±0.83) mm Hg, the distal contraction integral of lower esophageal sphincter was(1293.50±53.14) [mm Hg/(cm·s)], which were higher than 17.78%,(57.18±3.48)%,(44.93±1.87) mm Hg,(17.32±0.45) mm Hg,(1076.12±51.32) [mm Hg/(cm·s)] of the functional heartburn group, respectively; in the gastroesophageal reflux disease group, the length of lower esophageal sphincter was(3.45±0.13) cm, which was longer than(2.98±0.17) cm of the functional heartburn group; and the differences were statistically significant(P<0.05). Conclusion The difference in esophageal motility between gastroesophageal reflux disease and functional heartburn is significant, and the functional heartburn is more prone to esophageal motility disorder.更多还原