老年胃食管反流病患者食管运动功能测定

目的 :旨在了解老年、非老年胃食管反流病 (GERD)患者食管动力学改变、食管酸暴露的情况。方法 :对 16例老年健康者、18例非老年健康者、46例老年GERD患者、2 3例非老年GERD患者进行食管测压和 2 4hpH监测。结果 :老年、非老年GERD伴食管炎组LESP显著低于相应对照组 ,老年、非老年GERD患者食管中远段收缩压下降 ,且伴有食管炎者更显著 ,老年组比非老年组压力降低更明显。老年GERD伴食管炎组pH >5min的反流次数明显高于无食管炎组 ,非老年GERD伴食管炎组pH <4时间百分比明显高于无食管炎组。结论 :老年、非老年GERD伴食管炎患者食管抗反流屏障功能、食管蠕动功能出现减退 ,且老年组食管蠕动功能减退重于非老年组。老年GERD患者食管损害与酸廓清减退有关 ,非老年GERD患者食管损害与酸暴露增加相关。

A study on esophageal motility in elderly with gastroesophageal reflux disease

Objective:To investigate esophageal motility and esophageal acid exposure in elderly and non-elderly patients with gastroesophageal reflux disease(GERD).Methods:Esophageal manometry and 24-hour pH monitoring were performed in elderly control group(n=16),non-elderly control group(n=18),elderly patients(n=46) and non-elderly patients(n=23).Results:Elderly and non-elderly patients with esophagitis showed a lower LESP as compared to corresponding controls.Elderly and non-elderly patients,especially with esophagitis,showed a lower pressure of contraction at the distal esophagus as compared to corresponding controls,and the pressure was lower significantly in elderly patients than in non-elderly patients.The subgroup of elderly patients with esophagitis had a higher number of reflux episodes lasting for more than 5 min than the subgroup of elderly patients without esophagitis.And the subgroup of non-elderly patients with esophagitis had a higher total percent of reflux time than the subgroup of non-elderly patients without esophagitis. Conclusions:The functions of esophagus antireflux and the peristaltic activity of the esophagus impaired in elderly and non-elderly GERD patients with esophagitis,and the esophagus peristalsis in elderly patients more severely impaired as compaired to non-elderly patients.The injury of esophagus in elderly GERD patients was associated with the delayed acid clearance,and the injury of esophagus in non-elderly GERD patients was associated with the increased acid exprosure.