内镜下贲门间隙增宽在诊断反流性食管炎中的价值

摘要

Objective　To investigate the clinic value of cardia widening in endoscopic diagnosis of reflux esophagitis.Methods　According to the width of cardia under endoscopy,24 patients with reflux esophagitis diagnosed by endoscopy were divided into wide cardia (group A,12 cases) and not wide cardia (group B,12 cases).All patients and control group (group C,20 cases) were given esophageal manometry and 24-hour esophageal pH monitoring.Results　The average lower esophageal sphincter pressure (LESP) of group A and group B was lower than that of group C (P＜0.01),so was the primary peristaltic amplitude of lower esophagus (P＜0.01).Various indices of 24-hour pH-metry of group A and group B were higher than those of group C (P＜0.01).Significant difference was noted in the LESP,the primary peristaltic amplitude of lower esophagus,and the various indices of 24-hour pH-metry between group A and group B (respectively,P＜0.01,P＜0.05,P＜0.01).The severity of reflux esophagitis (RE) in group A was more serious than that in group B (P＜0.05).There was correlation between the severity of RE and the width of cardia under endoscopy (P＜0.05).Conclusion　Cardia widening is an important morphological characteristic of RE in endoscopic diagnosis,having a proper value in the endoscopic diagnosis of RE.%目的探讨贲门间隙增宽在内镜诊断反流性食管炎(RE)的价值。方法 24例经内镜诊断RE患者，根据反看贲门间隙的大小分为贲门间隙增宽组(A组，12例)、贲门间隙不增宽组(B组，12例)，分别行食管测压及24 h pH监测并与正常对照组(C组，20例)比较。结果 A组、B组的食管下端括约肌压力(LESP)、食管原发蠕动收缩波幅、24 h pH监测6项指标均与C组比较差异有显著性(P＜0.01)。A组与B组比较，食管炎程度差异有显著性(P＜0.05)，LESP(P＜0.01)、食管原发蠕动收缩波幅(P＜0.05)及24 h pH监测6项指标(P＜0.01)比较差异均有显著性。不同程度RE与贲门间隙宽度有相关性(P＜0.05)。结论内镜下贲门间隙是否增宽是内镜诊断RE的重要形态学特征，在内镜诊断RE中有一定的价值。