摘要
目的 探讨食管压力测定及食管 2 4hpH监测的各项指标与胃食管反流病 (GERD)患者食管炎发生的关系。方法 用Bio LAB消化道测压系统和Biostar2 4hpH监测系统检测了反流性食管炎与非食管炎GERD患者的各项食管运动功能及反流指标 ,并对这些指标进行Logistic多元回归分析。结果 食管炎组 2 4hpH监测各项指标均明显高于非食管炎组 ,二者的总积分分别为 113 2 9± 2 6 73和42 6 6± 11 2 5 (P <0 0 0 2 ) ,两组的LESP分别为 7 5 8±0 98和 10 16± 1 0 2 ,均明显低于正常人 (15 31± 0 99,P <0 0 0 1,P <0 0 5 ) ,且食管炎组明显低于非食管炎组 (P <0 0 5 )。食管炎组食管中、下段蠕动波压力明显低于正常人与非食管炎组 (P <0 0 0 1) ,非食管炎组与正常人比较差异无统计学意义。将以上单因素比较的 7项有显著性差异的指标进行Logitic多元回归分析 ,结果显示其中 3项指标对于食管炎的发生具有显著性意义 ,即食管下段蠕动波压力 (P <0 0 5 )、pH <4时间 %(P <0 0 3)及DeMeester Johnson总积分 (P <0 0 1) ,食管下段蠕动波压力越低 ,食管pH越低 ,DeMeester Johnson总积分越高 ,发生食管炎的可能性越大。结论 食管内酸清除能力的降低是造成食管内酸反流时间长 ,从而引起食管炎的重要的病理因素。
Objective To evaluate the changes in esophageal pressure and 24h pH on the pathogenesis of esophagitis by means of a multivariate logistic regression analysis of obtained values. Methods Monovariate comparison of parameters from 24h ambulatory esophageal pH measurements and esophageal manometry between two groups of gastro-esophageal reflux disease (GERD) patients, including 45 with esophagitis, 40 without esophagitis, and 42 healthy controls. Multivariate logistic regression analysis of parameters obtained was carried out. Results All parameters of DeMeester-Johson score were significantly higher in esophagitis than those of without esophagitis. The composite scores were 113.29±26.73 and 42.66±11.25, respectively (P<0.002). LESP were significant lower in two groups of GERD patients(7.58±0.98 and 10.16±1.02kPa) than that in controls (15.31±0.99kPa)(P<0.001 and P<0.05). GERD with esophagitis showed lower amplitude of peristalsis in middle and lower segments of esophagus than those without esophagitis and controls (P<0.001). Among the 7 indexes with significant difference by monovariate analysis, three significant independent parameters were identified by multivariate logistic regression analysis: amplitude of peristalsis in lower esophagus (P<0.05), pH<4 time%(P<0.03), and composite DeMeester-Johson score (P<0.01). Conclusion These approaches confirm that impaired esophageal acid clearance and hypotonicity of lower esophagus are the two major pathophysiological factors of pathogenesis of esophagitis.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2003年第10期917-919,共3页
Medical Journal of Chinese People's Liberation Army
关键词
胃食管反流
食管炎
压力
氢离子浓度
gastro-esophageal reflux
esophagitis
pressure
hydrogen-ion comentration
