功能性消化不良者心理因素与食管动力的关系

目的探讨心理因素与功能性消化不良(FD)食管动力的关系。方法使用高分辨率旁道灌注测压系统对20例健康对照组及121例FD进行食管动力测定,同时以焦虑自评量表及抑郁自评量表评定两组的心理状态,并观察食管动力与心理状态的联系。结果9.8%(24/121)的FD患者有食管动力障碍,主要表现为非特异性食管动力障碍70.8%(17/24);胡桃夹食管2例、弥漫性食管痉挛5例;60.7%(73/121)的FD者有心理障碍,其中抑郁障碍38.0%(46/121)、焦虑障碍48.8%(59/121),对照组1例有轻度的抑郁障碍,P<0.01。有心理障碍FD者食管动力障碍发生率(26.0%,19/73)比非心理障碍FD者(10.4%,5/48)显著增高(P<0.05),且前者LES压力、食管体蠕动波幅、持续时间均显著高于后者(P<0.05)。结论食管动力障碍是FD重要功能紊乱之一,长期抑郁或焦虑可能影响FD食管动力。

Psychologic factors and esophageal motility in patients with functional dyspepsia

Objective To investigate the relationship between psychologic factors and the esophageal motility of FD patients.Methods The esophagus kinetic was determined by using the polygraph HR manometry examination system in 20 cases health control and 121 patients diagnosed as having FD.We examined the relationship between the esophagus kinetic and psychiatric factors in the test groups and compared them with a control group.Results Of the FD patients,9.8% had esophageal motility disorders.Such as nonspecific esophageal motility disorder(70.8%),nutcracker esophagus(2 cases)and diffuse esophageal spasm(5 cases).In 73(60.7%)of 121 FD patients,psychiatric disorders(38% had depressive disorder and 48.8% had an anxiety disorder)were diagnosed following self-rating depression scales and anxiety scales.Only one case of control group had light depressive disorder(P<0.01).There were significant difference in the incidence rate of esophageal motility disorder between FD patients with psychiatric disorders and FD patients without psychiatric disorders.Conclusions Esophageal dysmotility is an important functional abnormality of FD.Long-term anxiety and depression seem to influence the esophageal motility of FD patients.