无效食管运动与胃食管反流病关系的探讨

Correlation between ineffective esophageal motility and gastroesophageal reflux disease

目的探讨无效食管运动（IEM）与胃食管反流病（GERD）的关系。方法对90例GERD全部进行胃镜检查并做食管压力测定和24h食管动态pH监测，其中反流性食管炎（RE）组62例，非糜烂性反流病（NERD）组28例。研究IEM与食管酸暴露及RE的关系。结果RE组中确诊IEM30例（48．4％）明显高于NERD组6例（21．4％）（P〈0．05）。36例IEM患者33例（91．7％）食管酸暴露阳性，高于食管动力正常患者（28／49，57．2％）（P〈0．01）；远端食管pH〈4总反流时间、卧位反流时间百分比、〉5min长反流周期数、最长反流时间、DeMeester评分IEM者明显高于食管动力正常者（P〈0．01），反流周期数前者明显高于后者（P〈0．05）。结论IEM在GERD中较常见，其食管动力障碍中绝大多数为IEM，IEM与食管远端酸暴露及RE密切相关。

Objective To investigate the correlation between ineffective esophageal motility （IEM） and gastroesophageal reflux disease （GERD）. Methods A total of 90 GERD patients were enrolled in our study, including 62 patients with reflux esophagitis （RE） and 28 with non-erosive reflux disease （NERD）. All the patients underwent gastroscopy, 24-hour esophageal pH monitoring and esophageal manometry. Re- sults In the RE group 30 （48.4%） patients were diagnosed as having IEM, which was significantly higher than the NERD group （6 patients, 21.4% ） （P 〈0.05）. Positive esophageal acid exposure was more often seen in patients with IEM than in those with normal esophageal motility （91.7% v.s. 57. 2% , P 〈0. 01 ）. The values of total percentage of time with pH 〈 4, percentage of reflux time in supine position, long-duration episodes （ 〉 5 rain） and the longest reflux time and DeMeester score were significantly higher in the IEM cases than those in the normal esophageal motility cases （ P 〈 0. 01 ） , so was the values of number of reflux episodes （P 〈 0. 05 ）. Conclusion IEM is the most common esophageal dysmotility in patients with GERD and closely related to distal esophageal acid exposure and RE.