摘要
目的:比较不同类型胃食管反流病(GERD),即反流性食管炎(RE)、非糜烂性反流病(NERD)和Barrett食管(BE)发病机制的差异.方法:113例GERD患者,根据内镜下表现及病理情况分为RE、NERD、BE三组,比较三组患者内镜下表现、食管测压和24hpH监测指标、合并食管裂孔疝(HH)情况的差异.结果:RE组较NERD组与BE组下食管括约肌压力减低,但无统计学差异.食管体部各段的收缩波幅比较,RE组减低最明显,NERD组减低最少,两组比较P<0.05;无效食管运功比较,RE组较另两组明显增多(P<0.05).RE、NERD、BE组24h食管pH监测的DeMeester计分分别为90.2、55.2、48.8;RE组以重度酸暴露多见(43%),反流总时间阳性率较高;NERD组以轻度酸暴露多见(45.8%),反流频率阳性率较高;BE组以长反流时间阳性率较高.HH在RE、NERD、BE组中的检出率分别为50%、14.6%、25.7%(P=0.003).结论:下食管括约肌及食管体部运动功能受损程度、酸反流情况的差异可能是造成三种不同类型GERD食管黏膜损伤表现不同的主要原因.
AIM： To investigate the differences in etiology for reflux esophagitis （RE）, non-erosive reflux disease （NERD） and Barrett＇s esophagus （BE）. METHODS： A total of 113 cases with gastro- esophageal reflux disease （GERD） were divided into three groups according to endoscopic mani- festations and pathological features. Endoscopic manifestations, indexes of the esophageal ma- nometry and intraesophageal pH monitoring in 24 h, and incidences of hiatal herniae （HH） were observed and compared in all the patients. RESULTS： Lower esophageal sphincter pres- sure （LESP） was noted in reflux esophagitis （RE） group than either NERD group or BE group, but no statistical significance was observed. The am- plitudes of esophageal body contraction in RE patients were lower than these in NERD patients （P 〈 0.05）. Compared with the other two groups, ineffective esophageal movements （IEMs） in RE patients were increased significantly （P 〈 0.05）. DeMeester scores in RE, NERD and BE patients were 90.2, 55.2 and 48.8, respectively （P 〈 0.05）.Severe acid exposion was common in RE patients （43%）, and light acid exposion was com- mon in NERD patients （45.8%）. The incidences of HH in RE, NERD and BE patients were 50%, 14.6%, 25.7%, respectively. It was higher in RE patients （P=0.003）. CONCLUSION： The differences of dysfunction of the LES and esophageal body, and also the differences of severity of acid exposion might be the most important reasons for different mucosa injuries among the three groups of GERD pa- tients.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第8期829-833,共5页
World Chinese Journal of Digestology
关键词
胃食管反流病
分型
发病机制
食管测压
PH监测
Gastroesophageal reflux disease
Group
Pathophysiologic mechanism
Esophagealmanometry
pH monitoring
作者简介
通讯作者：蓝宇，100035，北京市，积水潭医院消化科．lanyu-mail@sohu.com电话：010-58517177
