胃食管反流病患者伴有或不伴有食管黏膜损伤与食管上、下括约肌压力相关性研究

摘要

目的 研究伴或不伴食管黏膜损伤的胃食管反流病(gastroesophageal reflux disease,GERD)患者在食管动力方面的差异.方法 回顾性分析2015年1月至2017年12月,解放军总医院就诊的有反酸、烧心、胸痛等症状的患者,24 h食管pH监测Demeester积分≥14.72分,根据内镜检查结果分为糜烂性反流病(ERD)组和非糜烂性反流病(NERD)组,比较2组患者食管动力学指标的变化.结果 NERD组与ERD组UESP平均值数值相似,差异无统计学意义(P=0.168).其余指标UESRP平均值、LESP最小值、LESP平均值、LESRP平均值、LESRP最大值、DCI中NERD组均高于ERD组,差异均有统计学意义(P＜0.001).NERD组平均年龄明显小于ERD组,差异有统计学意义(P＜0.000 1).NERD组患者身高较ERD组偏低,体重较轻,身体质量指数(body mass index,BMI)也较小,差异有统计学意义(P＜0.000 1).结论 随着年龄的增大或BMI的增加,可能增加GERD患者食管黏膜损伤的风险.此外,糜烂性反流病患者较非糜烂性反流病的上、下食管括约肌动力障碍更严重.%Objective To study esophageal motility differences with or without esophageal mueosa injury in gastroesophageal reflux disease (GERD).Methods A retrospective analysis of patients with symptoms such as acid reflux,heartburn,chest pain and other symptoms was performed in the PLA General Hospital from January 2015 to December 2017.The 24-hour esophageal pH monitoring had a Demeester score ≥ 14.72 points.The erosive esophagus was classified according to endoscopic findings.In the erosive reflux disease (ERD) group and non-erosive reflux disease (NERD) group,changes in esophageal kinetic parameters were compared between the two groups.Results The average value of UESP in NERD group and ERD group was similar,with no significant difference (P=0.168).The UESRP,LESP,LESP,LESRP,LESRP and DCI were higher in NERD group than those in ERD group (P＜0.001).The average age of NERD group was significantly lower than ERD group (P＜0.000 1),with statistical significance.The height of NERD group was lower than ERD group,and the body weight and the BMI were both smaller in NERD group.The data of three groups were statistically significant.Conclusion With age growing and BMI increasing,the severity of GERD may be worse.In addition,the upper and lower esophageal sphincter dysfunction in patients with ERD are more critical than NERD.