食管混合性酸反流和低动力在非心源性胸痛发作的作用研究

目的胃食管反流病（GERD）是引起非心源性胸痛（NCCP）的最常见因素，本研究探讨酸反流和食管动力障碍在NCCP患者中的作用。 方法按照纳入、排除标准选取2018年9月至2019年6月在新疆维吾尔自治区人民医院急救中心以及微创，疝和腹壁外科住院收治的40例NCCP患者和50例典型GERD症状患者，两组患者均行食管24 h pH监测以及高分辨率食管测压监测。 结果NCCP组食管远端收缩平均积分（DCI）明显低于GERD组，并具有统计学意义（P＜0.05），提示食管运动功能受损。在NCCP组患者中，与胸痛有关的混合性酸反流明显高于GERD组（P＜0.05）。在NCCP组患者中，与NCCP相关的反流发作在食管5、9和15cm处的反流清除时间比GERD组患者期长（28.3±4.21)s vs(22.6±3.28)s；(13.7±1.32)s vs (18.3±1.47)s；(9.58±1.02)s vs(14.3±1.06)s（P＜0.05）。 结论酸反流性质，食管运动功能受损和延缓反流清除时间与NCCP患者症状发作可能存在密切的关系。

The role of mixed acid reflux and esophageal motility disorder in the occurrence of non-cardiac chest pain

ObjectiveGastroesophageal reflux disease (GERD) is the most common cause of non-cardiogenic chest pain (NCCP). This study aimed to investigate the role of acid reflux patteren and esophageal motility in patients with NCCP. MethodsAccording to inclusion and exclusion criteria, 40 patients with NCCP and 50 patients with typical GERD symptoms who diagnosed from September 2018 to June 2019 in Xinjiang Uygur Autonomous Region People’s Hospital were enrolled. Patients in both groups were asked to complete 24 h esophageal pH monitoring and high resolution esophageal manometry. ResultsThe mean value of distal esophageal contraction (DCI) in NCCP group was significantly lower than that in GERD group (P＜0.05), suggesting impaired esophageal motor function. In NCCP group, mixed acid reflux that related to chest pain were significantly higher than those in GERD group (P＜0.05). In NCCP group, the clearance time of reflux associated with NCCP at 5, 9 and 15 cm of esophagus was longer than that in GERD group (28.3±4.21) s vs (22.6±3.28) s; (13.7±1.32) s vs (18.3±1.47) s; (9.58±1.02) s vs(14.3±1.06) s (P＜0.05). ConclusionThe impairment of esophageal motor function, the nature of acid reflux and delayed clearance of reflux are may closely related to symptomatic seizures in NCCP patients.