健康志愿者和胃食管反流病患者食管动力的性别差异

Gender Differences of Esophageal Motility in Healthy Volunteers and Patients with Gastroesophageal Reflux Disease

背景:食管动力受多种因素影响,性别因素对食管动力的影响尚不清楚。目的:探讨健康志愿者、非糜烂性反流病(NERD)和反流性食管炎(RE)患者食管动力的性别差异。方法:83例健康志愿者以及具有典型胃食管反流症状的NERD患者196例和RE患者104例纳入本研究。受试者行食管测压,测定下食管括约肌压力(LESP)和食管体部运动功能(包括食管体部各段蠕动收缩波幅、蠕动波传导速度和湿咽成功率)。结果:RE组男性患者比例显著高于NERD组(69.2%对43.4%,P<0.05)。健康对照组和NERD组男性基础LESP较女性显著降低(P<0.05),男性健康志愿者食管体部近端蠕动收缩波幅显著低于女性(P<0.05),男性RE患者湿咽成功率显著低于女性患者(P<0.05)。男性NERD患者LESP降低发生率显著高于女性患者(45.9%对29.7%,P<0.05),男性RE患者食管体部运动功能障碍发生率显著高于女性患者(68.1%对46.9%,P<0.05)。结论:无论是胃食管反流病(GERD)患者还是健康志愿者,男性的食管动力均较女性差,男性性别是GERD发病的危险因素之一。

Background： Esophageal motility is affected by various factors, however, the effect of sex factors on the motor function of esophagus is not clear yet. Aims： To evaluate the gender differences of esophageal motility in healthy volunteers and patients with non-erosive reflux disease （NERD） and reflux esophagitis （RE）. Methods： Standard esophageal manometry was performed in 300 patients with typical gastroesophageal reflux symptoms, including 196 NERD and 104 RE, and in 83 healthy volunteers. Lower esophageal sphincter pressure （LESP） and peristalsis of esophageal body （including amplitude and velocity of peristalsis, and success rate of wet swallowing） were determined. Results： The proportion of males in RE was higher than that in NERD （69.2% vs. 43.4%, P〈0.05）. In healthy volunteers and NERD patients, the basic LESP was lower in males than that in females （P〈0.05）. Normal healthy females had significantly higher peristalsis amplitude of proximal esophagus than males （P〈0.05）. Tile success rate of wet swallowing of males was lower than that of females in patients with RE （P〈0.05）. Gender differences were observed in the incidence of declined LESP in NERD patients （men 45.9% vs. women 29.7%, P〈0.05） and abnormal esophageal body peristalsis in RE patients （men 68.1% vs. women 46.9%, P〈0.05）, respectively. Conclusions： Abnormal esophageal motility is more common in males in patients with gastroesophageal reflux disease （GERD） and healthy volunteers. Male may be a risk factor for GERD.