肠易激综合征患者食管运动功能变化

ESOPHAGEAL MOTOR FUNCTION IN IRRITABLE BOWEL SYNDROME

为探讨肠易激综合征(IBS)患者的食管症状与其运动功能及病理变化之间的关系。对正常人、IBS 有症状和无症状者及非 IBS 的有食管症状者行上消化道内镜、病理检查、食管测压和食管24小时 pH 监测。结果:(1)IBS 患者食管内镜和病理检查异常者显著高于正常组和无症状组。(2)IBS 有症状组食管下段平滑肌压力(LESP)显著低于正常组和无症状 IBS 组;(3)两组 IBS 患者食管下段蠕动间期和传导速度显著高于正常组;并且存在着同步收缩、重复收缩等异常蠕动。(4)UES 压力在 IBS 患者无显著异常。(5)IBS有症状组 pH 总分、总暴酸时间百分比及最长暴酸时间均显著高于正常人和无症状 IBS者。结论:IBS 患者常合并食管症状。LES 压力降低,胃食管反流为这些症状产生的主要因素。

Patients with irritable bowel syndrome(IBS,n=41)subjected to gastroscopy,patholo- gy,esophageal manometry and 24h pH monitoring.The records were compared with that of normal in- dividuals(n=30)to clarify the relation of esophageal motor function with esophageal complaints in cas- es with IBS.Results showed that 21/41 cases with IBS presented esophageal symptoms.Rate of abnor- mal endoscopic and pathologic findings in 6 of which was statistically higher than the control's; esophageal lower sphincter pressure in IBS with symptoms declined significantly than that without and the control;esophageal peristaltic velocity and duration increased with significance;no pressure differ- ence was detected in esophageal upper sphincter;total pH score ,fraction-time pH<4 and maximum re- flux episode in 1BS augmented obviously.Conclusively,esophageal symptoms would be included in the syndrome,the former might be resulted from reduced esophageal lower sphincter pressure,gastric re- flux,as well as abnormal peristalsis.