不同亚型贲门失弛缓症的食管动力学特点的研究

目的 研究贲门失弛缓症患者的临床特点及不同亚型患者食管动力学特点的差异.方法 纳入24例贲门失弛缓症患者行食管测压检查并分型,观察贲门失弛缓症临床特点,同时对不同亚型患者的食管动力学参数进行比较.结果 ①24例贲门失弛缓症患者均有吞咽困难不适,伴有反流症状13例(13/24,54. 17％),I型患者伴发反流不适症状更为常见(P=0. 015);②24例贲门失弛缓症患者的食管测压结果均为食管同步蠕动,而且均存在食管下括约肌残余压升高和食管下括约肌松弛不完全,食管下括约肌静息压升高的患者有5例(5/24,20. 83％), Ⅱ型患者的食管体部近端蠕动压力和食管体部远端蠕动压力均高于I型患者(P＜0.05).结论 贲门失弛缓症不同亚型具有不同的临床特点和食管动力学特点,对于怀疑贲门失弛缓症的患者建议进行食管测压检查可以明确诊断和进行分型,有利于治疗方案的选择和预后评价.

Research on esophageal motility characteristics between different subtypes of achalasia of cardia

Objective To investigate the clinical characteristics of achalasia of cardia and discrepancies in esophageal motility characteristics between different subtypes of achalasia of cardia. Methods A total of 24 patients with achalasia of cardia were enrolled in this study and were classified into different subtypes by means of esophageal manometry, then observed the clinical characteristics of achalasia of cardia and compared parameters of esophageal manometry between different subtypes of achalasia of cardia. Results ① 24 patients suffered dysphagia, among which 13 patients(13/24, 54. 17％ ) suffered regurgitation, the clinical characteristic of regurgitation was commoner in type I achalasia of cardia (P =0. 015);② The result of esophageal manometry expressed that all of 24 patients showed esophageal synchronous peristalsis, lower esophageal sphincter remaining pressure rise and incomplete lower esophageal sphincter relaxation. Meanwhile, 5 patients(5/24, 20. 83％ ) showed lower esophageal sphincter resting pressure rise, and proximal esophageal pressure as well as distal esophageal pressure became higher in type II achalasia of cardia than type I (P ＜ 0. 05). Conclusion Different subtypes of achalasia of cardia show different clinical characteristics and esophageal motility characteristics. Patient who is suspicious of suffering from achalasia of cardia would better undergo esophageal manometry so as to make a definite diagnosis and confirm subtype, which is useful for making a good choice of treatment and forecasting prognosis.