胃食管反流病食管测压与24小时pH监测的相关性研究

目的：对５２例有胃食管反流症状的患者进行食管测压及２４小时ｐＨ监测，运用统计学方法分析测压和ｐＨ结果，研究其相关性。方法：应用多导胃肠功能测定仪及便携式ｐＨ监测记录仪，对５２例有胃食管反流症状的患者进行食管测压及２４小时ｐＨ监测。结果：应用多元回归分析发现，ｐＨ的百分比和腹段下食管括约肌（ＬＥＳ）的长度、ＬＥＳ静息压及远端食管的蠕动压明显相关。依据测压及ｐＨ结果，使用ｔ检验方法，结果提示食管蠕动压不仅与ｐＨ＜４的百分化相关，也与酸反流大于５分钟的时间、最长反流时间有关（Ｐ＜００１）。结论：腹段ＬＥＳ的长度及食管下段的蠕动收缩是重要的抗反流屏障。食管酸暴露时间延长减弱食管体部酸清除能力

Correlation between Esophageal Motility and 24 Hour pH Recording in Patients with Gastroesophageal Reflux Disease

Aims:To investigate the relationship between esophageal motility and pH metric date in gastroesophageal reflux disease.Methods: We studied in a group of 52 patients with symptoms of gastroesophageal reflux.Esophageal manometry and twenty four hour pH monitoring was performed in all patients with a PC Polygraf HR system and synectics portabel pH measuring unit. Results:Using a multiple regression analysis,we found that total percentage of reflux was significantly correlated to the infradiaphragmatic length and resting pressure of the lower esophageal sphincter (LES) and also to the mean amplitude of the contractile waves of the distal esophagus.Usingt test, we found that the amplitude of the contractile waves were related not only to the total percentage of reflux but also to the number of reflux episodes of greater than 5 min duration and to the duration of the longest episode.Conclusion:Infradiaphragmatic length and resting pressure of the LES were important in antireflux mechanism.Prolonged exposure of the esophageal mucosa to the refluxed material can reduce the capacity for esophageal clearing.