反流性食管炎患者食管动力学改变对疗效的影响

目的探讨反流性食管炎（RE）患者不同食管动力障碍对抑酸剂及促胃肠动力剂的治疗反应，为临床RE的治疗提供方法学选择。方法对临床及胃镜诊断为RE的104例患者进行食管压力测定，并同时进行14d的埃索美拉唑及莫沙比利分散片治疗，观察不同食管动力障碍患者的疗效。结果经14d治疗，104例患者临床症状改善情况：显效64例，有效32例，总有效率为92．3％，其中治疗A组（LESP降低或正常，伴食管蠕动减弱者）疗效明显优于治疗B组（LESP增高或正常，或伴食管腔压力增高）（P〈0．01）。结论对抑酸剂及促动力药物疗效欠佳的RE患者，可能存在不同的食管动力障碍，食管测压可能对此有一定的鉴别意义，而在治疗时不应常规给予治RE药物，应体现个体化治疗原则。

Therapeutic effect of different esophageal disorders of motility in patients with reflux esophagitis

Objective To study the therapeutic effect of antiacids agents and gastrointestinal prokinetie agents in patients with reflux esophagit(RE) by esophageal manometry.Methods 104 patients with RE were cured for fourteen days with esomeprazole and mosapride after esophageal manometry measured and their therapeutic effect were assessed by different esophageal disorders of motility.Results The symptoms of patients with RE were relieved after fourteen days,the noticeable effective rates was 61.5%(64/104),the effective rate was 30.7%(32/104),the total effective rate was 92.3%.The therapeutic effect of group A who had the lower esophageal sphincter pressure(LESP) was greater than that of group B whose resting LES pressure were high(P<0.01).Conclusion The patients with RE have different esophageal disorders of motility,therefore,they have different therapeutic effect with antiacids agents and gastrointestinal prokinetie agents.