胃食管反流病动态特征与症状之间的相关性分析

Yan Tian, Weihao Zhang, Tingting Zhang, Lan Liu, Jianqiang Guo
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摘要

目的:研究胃食管反流病(GERD)的食管运动特征及其与症状的关系:研究胃食管反流病(GERD)的食管运动特征及其与症状的关系:我们对 101 名经内镜检查确诊为胃食管反流病的患者进行了检查,并将他们分为以下三组:非侵蚀性反流病(NERD)、反流性食管炎和巴雷特食管。采用食管高分辨率测压法和胃食管反流病问卷调查食管动态特征和症状。此外,还填写了反流症状指数,并根据症状将患者分为 7 组。然后,我们确定了食管动态特征与临床症状之间的相关性:结果:RE 组食管上括约肌压力(UES)和食管下括约肌压力(LES)以及 4 秒综合松弛压力均低于 NERD 组。巴雷特食管组的 4 秒综合松弛压也低于 NERD 组。在分析食管外症状时,高分辨率测压法显示各组之间的上消化道压力存在显著差异。进一步的亚组分析显示,与无食管外症状组相比,有咽异物感、清嗓子和多种食管外症状组的上咽部压力较低:结论:随着胃食管反流病严重程度的增加,LES和食管体的运动功能障碍逐渐加重,LES在胃食管反流病的发生发展中起着重要作用。上咽部压力下降在食管外症状的发生中起着重要作用,这在有咽部异物感和清嗓症状的患者中更为明显。
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Analysis of the Correlation Between Dynamic Characteristics and Symptoms of Gastroesophageal Reflux Disease.

Objective: To investigate the esophageal motility characteristics of gastroesophageal reflux disease (GERD) and their relationship with symptoms.

Patients and methods: We examined 101 patients diagnosed with GERD by endoscopy and divided them into 3 groups as follows: nonerosive reflux disease (NERD), reflux esophagitis, and Barrett esophagus. Esophageal high-resolution manometry and the GERD Questionnaire were used to investigate the characteristics of esophageal dynamics and symptoms. In addition, the reflux symptom index was completed and the patients were divided into 7 groups according to symptoms. We then determined the correlation between dynamic esophageal characteristics and clinical symptoms.

Results: Upper (UES) and lower (LES) esophageal sphincter pressures and the 4-second integrated relaxation pressure in the RE group were lower than those in the NERD group. The 4-second integrated relaxation pressure in the Barrett esophagus group was also lower than that in the NERD group. In the analysis of extraesophageal symptoms, high-resolution manometry showed significant differences in UES pressures among all groups. Further subgroup analysis showed that compared with the group without extraesophageal symptoms, the UES pressure of the groups with pharyngeal foreign body sensation, throat clearing, and multiple extraesophageal symptoms was lower.

Conclusions: As GERD severity increases, motor dysfunction of the LES and esophageal body gradually worsens, and the LES plays an important role in GERD development. Decreased UES pressure plays an important role in the occurrence of extraesophageal symptoms, which is more noticeable in patients with pharyngeal foreign body sensation and throat clearing.

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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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