摘要
目的探讨癔球症患者食管上括约肌(UES)压力分型及其严重程度的影响因素。方法120例癔球症患者采用高分辨率食管测压技术(HRM)检测食管上括约肌静息压,将其分为高压组和非高压组;并进行癔球症症状评分(GETS),匹兹堡睡眠质量指数(PSQI)及汉密顿焦虑/抑郁量表(HAMA/HAMD)评估。结果 24.2%(29/120)的癔球症患者存在UES高压,而33.3%(40/120)的癔球症患者存在UES残余压过高。高压组与非高压组相比,在病程持续时间[(42.17±50.11)月,(20.67±17.07)月]、GETS评分[(11.79±3.49)分,(7.81±2.12)分]、UES静息压[(131.38±22.38)mmHg,(66.83±16.98)mmHg,1 mmHg=0.133 kPa]、HAMA评分[(13.59±2.84)分,(8.08±1.46)分]等指标差异有统计学意义(t=4.175,3.957,4.126,3.382;P<0.05)。癔球症患者的GETS评分与UES静息压(r=0.617)、UES残余压(r=0.265)、HAMA评分(r=0.531)呈显著正相关(P<0.05),而与LES静息压(r=0.012)、PSQI评分(r=0.082)、HAMD评分(r=0.105)等指标无明显相关性(P>0.05)。多重线性回归分析显示,UES静息压、UES残余压、HAMA评分是癔球症症状严重程度的影响因素,最终拟合癔球症症状影响因素的方程:癔球症症状严重程度(GETS评分)=2.813+0.040(UES静息压)+0.059(UES残余压)+0.206(HAMA评分)。结论 UES静息压过高在癔球症患者中并不少见,与非高压型患者相比,高压性患者癔球症症状持续时间长、症状严重程度高、焦虑状态更严重;癔球症症状严重程度与UES静息压、UES残余压、HAMA评分等因素有关。
Objective To explore the types of upper esophageal sphincter （ UES ） pressure and influencing factors in patients with globus pharyngeus.Methods UES resting pressure of 120 patients with globus pharyngeus were taken by high resolution manometry （ HRM ） , and all patients were evaluated by Glasgow Edinburgh Throat Scale （ GETS） ,Pittsburgh Sleep Quality Index （ PSQI） and hamilton Rating Scale Anxiety/Depression（HAMA/HAMD）.According to the UES resting pressure,the 120 patients were divided into hypertensive UES group and non-hypertensive UES group.Results 24.2%（29/120） of globus pharyngeus patients had high UES resting pressure,while 33.3%（ 40/120） of globus phyaryngeus patients had high UES residual pressure.Hypertensive UES patients had longer symptom duration [（42.17±50.11）months,（20.67± 17.07）months],more severe symptom [（11.79±3.49） points,（7.81±2.12） points],higher UES resting pressure [（131.38±22.38）mmHg,（66.83±16.98）mmHg],higher HAMA scores [（13.59±2.84）points,＆amp;nbsp;（8.08±1.46）points],compared with non-hypertensive UES group （t =4.175,3.957,4.126,3.382; P 〈0.05） .The severity of globus pharyngeus symptoms was associated with UES residual pressure, UES resting pressure,HAMA scores.Multiple linear regression analysis showed that UES residual pressure,UES resting pressure,HAMA scores were influencing factors of globus symptoms.Conclusions Hypertensive UES is not rare among globus patients.Hypertensive UES patients have longer symptom duration,more severe symptom, higher UES resting pressure,higher HAMA scores.The severity of globus pharyngeus symptoms is associated with symptom duration,UES residual pressure,UES resting pressure,HAMA scores.
出处
《中华诊断学电子杂志》
2016年第3期153-156,共4页
Chinese Journal of Diagnostics(Electronic Edition)
关键词
癔球症
食管括约肌
上段
高分辨率食管测压
Globus pharyngeus
Esophageal sphincter,upper
High resolution manometry
