摘要
目的了解我国贲门失弛缓症患者食管运动障碍的特征。方法调查了１４７例确诊为贲门失弛缓症患者的临床表现，并对其中１０２例进行食管压力测定。结果男女发病的比例为１∶１．２，发病年龄在２０～５０岁之间的占８５％。食管测压表现为：５６．９％患者ＬＥＳＰ在２０～４０ｍｍＨｇ（２．７～５．３ｋＰａ）之间，２２．５％的患者ＬＥＳＰ＜２０ｍｍＨｇ（２．７ｋＰａ），ＬＥＳ松弛率与ＬＥＳＰ的高低无关（Ｐ＞０．１）；１０２例中有５６例出现较为完全的（ＬＥＳＲＲ＞７０％）ＬＥＳ松弛，包括吞咽后及非吞咽时出现的松弛，松弛的时限在４．８～１４．４秒之间，且松弛的时限与松弛率无关；食管体部的测压图形表现为低平型、强力型、中间型三种类型；ＵＥＳ未见异常。结论ＬＥＳＰ升高不是诊断贲门失弛缓症的必备条件；贲门失弛缓症可出现吞咽后或无吞咽时的ＬＥＳ松弛；食管体部波形不同的原因可能与支配ＬＥＳ的神经纤维受损程度不同有关。本研究为食管扩张治疗贲门失弛缓症提供了有用的信息。
Objective To investigate the characteristics of both clinical manifestation and esophageal motor disturbance in Achalasia among Chinese. Methods Clinical manifestation in 147 cases of achalasia, esophageal motor function in 102 cases were investigated. A pneumhydroulic capillary perfusion system with an 8 lumen Dent Sleeve catheter was used to record esophageal manometry through polygraph after overnight fasting. Patients received 6 10 swallows with 5ml of water during recording. Results Of 147 cases, ratio of male to female was 1∶1.2. Eighty five % of patients were between 20 and 50 years of age. The characteristics of esophageal manomtry were shown as follows: (1) LESP in 22.5% was <20mmHg(2.7kPa), 56.9% 21 40mmHg(2.7 5.3kPa), only 0.98% was over 60 mmHg (8.0kPa). (2) LES relaxations were found 112 times in 56 patients (54.9%), of those, 53 relaxations occurred after swallowing of water (7.2% of total swallows), and 69 relaxations occurred without swallowing. There was no difference in duration between the two types of relaxation. (3) Three motor patterns of esophageal body included 27.5% with hypomotility type (amplitude of contraction <10mmHg, <1.3kPa), 10.8% with vigorous type (amplitude of contraction >60mmHg, >8kPa), 61.7% with intermediate type (amplitude of contraction between 10 60mmHg (1.3 8.0kPa), irregular contraction). (4) No abnormality of UES was detected. Conclusion (1) Cases from 102 Chinese with Achalasia did not show high LESP. (2) Complete or relatively complete LES relaxation (LESRR>70%) occurred in 54.9%. (3) These were 3 types of motor patterns of esophageal body. These data will be helpful for understanding of the pathophysiology, the involved level, severity, which will offer useful information for further therapy.
出处
《中华消化杂志》
CAS
CSCD
北大核心
1999年第2期100-103,共4页
Chinese Journal of Digestion
