摘要
目的探讨老年反流性食管炎(reflux esophagitis,RE)患者的食管运动功能特点,为老年RE患者的个体化治疗提供理论依据。方法回顾性分析经内镜诊断并行食管测压及(或)食管24 h p H值动态监测的老年RE患者77例与同期检出的中青年RE患者84例,分析2组患者的内镜分级及食管运动功能特点。结果老年组中重度食管炎所占比重明显高于中青年组(P<0.05)。老年组下食管括约肌压力(Lower esophageal sphincter pressure,LESP)、食管体部压力明显低于中青年组(P<0.05),老年组无效食管运动(ineffective esphageal motility,IEM)检出率明显高于中青年组(P<0.05)。老年组立位pH<4时间%、卧位pH<4时间%、pH<4总时间%、反流>5 min次数、最长反流持续时间、DeMeester评分明显高于中青年组(P<0.05),病理性酸反流检出率明显高于中青年组(P<0.05)。结论 RE食管黏膜破损程度老年人重于中青年人。老年RE患者抗反流能力减弱、食管酸廓清能力下降严重,出现更明显的食管运动功能障碍。
Objective To explore the esophageal motility features of elderly patients with reflux esophagitis（RE）,and to provide the theoretical basis for the treatment of elderly patients with RE. Methods seventy-seven elderly patients with RE and 84 younger patients with RE detected in our hospital for the past three years were included in this study.All patients accepted esophageal manometry and 24- hour esophageal p H monitoring after endoscopic diagnosis. The endoscopic presentations and esophageal motility features were analyzed. Results The proportion of moderate to severe esophagitis in elderly group was higher than that of younger group（P〈0.05）. Lower esophageal sphincter pressure and esophageal body pressure of the elderly group were significantly lower than that of the younger group（P〈0.05）. Proportion of ineffective esphageal motility in the elderly group was significantly higher than that of younger group（P〈0.05）.As regard as percent of upright time pH〈 4, the percent of supine time of pH 〈4, percent of total time pH 4 and the times of reflux time greater than 5 minutes, the longest reflux duration and De Meester score, the elderly group was significantly higher than that of the younger group（P〈0.05）. Proportion of pathological acid reflux in the elderly group was significantly higher than that of younger group（P〈0.05）. Conclusion The degree of damage caused by reflux esophagitis increases gradually with age. In elderly patients with RE, their capacity of anti-reflux and esophageal acid clearance is significantly decreased and esophageal dysmotility is more severe.
出处
《北京医学》
CAS
2016年第1期9-11,共3页
Beijing Medical Journal
关键词
反流性食管炎
老年
食管运动功能
Reflux esophagitis
Elderly
Esophageal motor function
作者简介
通信作者：张玫，Email：zhang2955@sina．com
