| 胡莹,丁百静.内镜下胃食管阀瓣分型与胃食管反流病食管动力的关系[J].安徽医药,2020,24(8):1549-1553. |
| 内镜下胃食管阀瓣分型与胃食管反流病食管动力的关系 |
| A preliminary study on the relationship between gastroesophageal flap valve classification under endoscope and esophageal motility in gastroesophageal reflux disease |
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| DOI：10.3969/j.issn.1009?6469.2020.08.017 |
| 中文关键词: 胃食管反流 胃镜检查 胃食管阀瓣 食管高分率测压 食管 pH监测 |
| 英文关键词: Gastroesophageal reflux Gastroscopy Gastroesophageal flap valve Esophageal high resolution manometry Esophageal pH monitoring |
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| 中文摘要: |
| 目的探讨内镜下胃食管阀瓣(GEFV)分型与胃食管反流病(GERD)食管动力的关系。方法回顾性分析 2015年 1月至 2018年 12月就诊于芜湖市第二人民医院诊断为 GERD病人 76例，均行内镜、食管高分辨测压、 24 h食管 pH监测，根据内镜下 HILL分级，将 GEFV分为 Ⅰ~Ⅳ级， Ⅰ级、 Ⅱ级为正常组， Ⅲ级、 Ⅳ级为异常组，比较两组内镜下表现、食管测压、 24 h食管 pH监测相关指标。结果异常组反流性食管炎(RE)、 Barrett食管(BE)检出率为 73.0%，高于正常组(41.0%)差异有统计学意义(P＜0.05)两组食管上括约肌静息压(UESP)［(57.69±32.65)mmHg比(56.32±28.50)mmHg］差异无统计学意义P＞0.05)，异常组食管下括静息压(LESP)［(7.93±3.85)mmHg比(19.64±5.95)mmHg］、远端收缩积分(DCI)［(223.59±195.67)mmHg·s-1·cm-1比(，约肌，(533.64±289.71)mmHg·s-1·cm?1］、 4s综合松弛压(IRP4s)［4.0(3.3，4.8)比 5.6(4.6，6.8)］低于正常组，差异有统计学意义(P＜0.05)。两组食管收缩模式、食管蠕动力度相比，差异无统计学意义(P＞0.05)，异常组 Demeester评分［9.02(7.28，16.28)分比 3.57(1.65，5.60)分］、酸反流次数［45.00(25.00，56.50)次比 15.00(10.00，32.00)次］、pH＜4所占的总时间百分比高于正常组，差异有统计学意义(P＜0.05)。结论 GEFV异常者内镜下阳性表现发生率高， GEFV可能参与食管抗反流机制，可以有效的预测反流。 |
| 英文摘要: |
| Objective To explore the relationship gastroesophageal flap valve(GEFV)classification under endoscope and esopha? geal motility in gastroesophageal reflux disease(GERD).Methods Data of a total of 76 GERD patients treated in The Second People’s Hospital from January 2015 to December 2018 were analyzed retrospectively.All the patients received endoscopy，esopha? geal high resolution manometry and 24?hour pH monitoring.According to the HILL classification，GEFV was assigned into Ⅰ to Ⅳ grades，and classified into two groups:normal GEFV(HILL grades Ⅰ and Ⅱ)，and abnormal GEFV(HILL grades Ⅲ and Ⅳ).En? doscopic findings，the esophageal manometry，and the 24?hour pH monitoring were analyzed and compared between the two groups. Results The detection rate of reflux esophagitis(RE)，Barrett esophagus(BE)in abnormal GEFV group was 73.0%，which was higher than that in normal GEFV group(41.0%)； the difference was significant(P＜0.05).There was no significant difference in upper esophageal sphincter pressure(UESP)between the two groups［(57.69±32.65)mmHg vs.(56.32±28.50)mmHg，P＞0.05］. Lower esophageal sphincter pressure(LESP)［(7.93±3.85)mmHg vs.(19.64±5.95)mmHg］，the distal contraction integral(DCI)［(223.59±195.67)mmHg·s?1·cm?1 vs.(533.64±289.71)mmHg·s?1·cm?1］and the 4 s comprehensive relaxation pressure(IRP4S)［4.0(3.3，4.8)vs. 5.6(4.6，6.8)］ were significantly lower in the GEFV abnormal group than those in normal GEFV group(P＜0.05). There were no significant differences in the esophageal contraction mode and the force of esophageal peristalsis between the two groups(P＞0.05).The Demeester score［9.02(7.28，16.28)score vs. 3.57(1.65，5.60)score］，acid reflux times［45.00(25.00，56.50) times vs. 15.00(10.00，32.00)times］，and the total time percentage caused by pH＜4 in the abnormal GEFV group were significantly higher than those in normal GEFV group(P＜0.05).Conclusion The incidence of positive findings under endoscopy is high in pa?tients with abnormal GEFV.GEFV may be involved in the mechanism of esophageal antireflux and can be used to predict reflux ef?fectively. |
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