胃食管反流病食管酸暴露和食管动力学变化特征

目的探讨无效食管动力(IEM)在胃食管反流病(GERD)中的作用,以及体质量对食管酸暴露及食管动力的影响。方法77例GERD典型症状患者全部行食管高分辨率压力测定(HRM)和24 h食管动态pH监测,分析IEM及正常食管动力患者酸暴露情况。结果 77例典型GERD症状患者中病理性酸暴露者38例(49%),在病理性酸暴露组中IEM 9例(24%),正常酸暴露组中IEM 5例(13%)。IEM组LES压力低于食管动力正常组(15.15±3.60 vs 22.15±6.73,P0.01);IEM组总pH4时间(百分比)较正常食管动力组高[(14.78±3.8)%vs(4.30±2.68)%,P0.01];IEM组患者BMI值较高。结论 IEM在GERD中较常见,其食管动力障碍中绝大多数为IEM,IEM与食管远端酸暴露密切相关。

Characteristics of esophageal acid exposure and motility on patients with gastroesophageal reflux disease

Objective To investigate the association between ineffective esophageal motility （IEM） and gastroesophageal reflux disease （GERD）,and the impact of body weight on esophageal acid exposure and motility.Methods A total of 77 patients who underwent HRM and ambulatory 24h pH monitoring due to reflux symptoms were enrolled.The characteristics of esophageal acid exposure in normal esophageal motility and ineffective esophageal motility were analyzed.Results Seventy-seven patients who presented with reflux symptoms,pathologic acid reflux was found in 38 cases （49％）.Ineffective esophageal motility was found in 9 cases （24％） in the pathologic reflux group and 5 cases （13％） in the functional reflux group.Lower esophageal sphincter （LES） pressure was lower in IEM group than that in esophageal motility normal group （15.15 ±3.60 vs 22.15 ±6.73,P ＜0.01）,and total reflux times was higher in IEM group than that in esophageal motility normal group [（14.78 ± 3.8） ％vs （4.30 ± 2.68） ％,P ＜ 0.01）].BMI in IEM group was more higher than that in normal motility group.Conclusion IEM is the most common esophageal dysmotility in patients with GERD and closely related to distal esophageal acid exposure.