非特异性食管动力障碍与胃食管反流病的关系研究

目的探讨非特异性食管动力障碍(NEMD)常见的临床类型,各类型与胃食管反流病(GERD)的关系。方法对食管测压检出的52例NEMD患者分别进行胃镜、食管内24h动态pH和胆汁监测,埃索美拉唑(耐信)治疗试验。结果NEMD主要类型有非传导性收缩43例、低幅性收缩39例、LES不松弛或松弛不全致LES残余压增高31例,多峰收缩9例。食管内24h动态pH和胆汁监测证实17例(32.7%)伴有病理性胃食管反流,伴有反流者多为不伴LES松弛功能障碍者,而LES松弛障碍者反流不明显,耐信治疗试验进一步证实了pH和胆汁监测的结果。结论NEMD部分与GERD相关,但更多可能为原发性食管动力障碍。

The Relationship of Nonspecific Esophageal Motility Disorder and Gastroesophageal Reflux Disease

Objective The aim of this study was to assess the clinical presentation,motility characteristics,and prevalence and patterns of nonspecific esophageal motility disorder(NEMD) and to assess the relationship of NEMD and gastroesophageal reflux disease.Methods 52 NEMD patients(30 women,22 men;mean age 33.8 years,range 19 to 58 years)were studied by using polygraf ID manometry examination system.Ambulatory pH monitor and Bilitic 2000,and all patients were evaluated with the therapeutic test of Esopmeprazole.Results The common motility abnormality in the NEMD patients were non-conductive contractions(82.7%),low amplitude peristalsis(75.0%),multiple peak peristalsis(17.3%)and high residual pressure measured during low esophageal sphincter(LES) relaxation induced by a water swallow(59.6%).The abnormal gastroesophageal reflux were diagnosed in 32.7% of NEMD patients,which was the common dysmotility in patients of non-conductive contractions and low amplitude peristalsis,but it was uncommon in patients of high residual pressure of LES.And it was also proved by the therapeutic test of Esopmeprazol.Conclusion A part of NEMD patients follow the abnormal gastroesophageal reflux,but the majority have not close relationship between NEMD and gastroesophageal reflux disease,they can be primary oesophageal motility disorders.