反流性食管炎、Barrett食管的食管动力学研究

目的 探讨反流性食管炎(RE)、Barrett食管(BE)的动力学改变。方法 经内镜检查3 400例患者,分 RE、BE、对照组,进行症状调查、食管测压、食管24h pH检测,并行统计学分析。结果 RE与BE组间除吞咽不适外,烧心感、反酸及胸骨后疼痛的症状评分均为RE组大于BE组,且差异有显著性意义。部分RE、BE、对照组间食管运动功能比较,食管下括约肌静息压等差异均无显著性意义。食管24 h pH检测DeMeester评分、pH<4总时间、pH<4时间的百分比等 RE、BE组高于对照组,差异有显著性意义,但RE、BE组间差别无显著性意义。结论 食管反流症状与食管黏膜的内镜下表现不一致;食管组织化生与食管运动功能间无相关。

Study on esophageal motor function in patients with reflux esophagitis and Barrett esophagus

Objective To study the esophageal motor function in patients with reflux esophagitis (RE) and Barrett esophagus ( BE). Methods Patients with reflux esophagitis and Barrett esophagus which were diagnosed by endoscopy were recruited for symptomatic investigation, Twenty-seven patients with RE, 18 patients with BE and 12 non-reflux patients as controls were recruited prospectively for stationary esophageal manometry and 24-hour ambulatory esophageal pH monitoring. Results Besides dysphagia, the symptom scores of heartburn, acid regurgitation and retrosternal pain in BE groups were lower than those in RE groups (P < 0. 05). There was no difference in static pressure of lower esophageal sphincter among RE, BE groups and controls (P>0. 05). DeMeester score of 24-hour ambulatory esophageal pH monitoring, total times of pH < 4, and percentage of time with pH < 4 in RE and BE groups were significantly higher than those in controls (P<0. 05) , but there was no significant difference between RE and BE groups. Conclusion There was no accordance between reflux symptom and esophageal mucosal lesion in endoscopy and no correlation between esophageal mucosal metaplasia and motor function.