老年胃食管反流病患者高分辨率食管测压压力特点分析

Characteristics of high resolution manometry on elderly patients with gastroesophageal reflux disease

目的探讨老年胃食管反流病患者高分辨率（HRM）测压压力特点。方法2011年6月至2012年9月对反酸、烧心伴胸骨后不适等症状的老年患者行HRM检测，分析其食管动力特点。结果老年反流性食管炎（RE）组的下食管括约肌（LES）总长度、腹腔内LES长度、LES平均静息压分别为（2．50±0．62）cm、（1．90±0．19）cm和（21．48±8．48）mmHg，低于老年非糜烂性反流病（NERD）组的（3．33±0．43）cm、（2．50±0．46）cm和（24．83±O．64）mmHg（P〈0．05）。结论老年RE患者存在明显的抗反流机制障碍，在其发病机制中可能发挥重要作用。而老年NERD患者的食管运动功能失调不明显，推测其他机制可能参与了其发病过程。

Objective To investigate the features of esophageal motility by using high resolution manometry （HRM） in elderly patients with gastroesophageal reflux disease. Methods The patients complaining acid regurgitation, heartburn and poststernal discomfort received HRM, and we analyzed the characteristics of esophageal motility in elderly patients with gastroesophageal reflux disease. Results The characteristics of lower esophageal sphincter （LES） in elderly reflux esophagitis （RE） patients were significantly lower than those of elderly non-erosive reflux disease （NERD） patients （P〈0.05）. The total length of LES, intra-abdominal length and the average of LES in elder RE group and NERD group were 2.50 ±0.62cm, 1.90 ±0.19cm,21.48 ± 8.48mmHg and 3.33 ±0.43cm, 2.50 ±0.46cm, 24.83 ±0.64mmHg, respectively. Conclusion Elder RE patients have disorders of anti-reflux barrier, which might play a important role in the pathogenesis. However, the mechanism of elder NERD was complex, which could not be explained simply by the destruction of anti- reflux barrier.