47例反流性食管炎食管阻抗基线的改变

Changes of esophageal intraluminal baseline impedance in 47 reflux esophagitis

目的 了解反流性食管炎患者食管阻抗基线的变化.方法 纳入2013年12月至2014年8月就诊的47例反流性食管炎患者与17名健康对照者.采用洛杉矶分级（LA）对反流性食管炎患者进行分级.所有受试者接受24 h多通道腔内阻抗测量（MII）-pH检查,测定其阻抗基线值.采用独立样本t检验比较两组的阻抗基线差异.采用Spearman秩相关方法分析食管酸暴露时间（AET）与反流性食管炎患者阻抗基线之间的关系.采用Kruskal-Wallis秩和检验分析不同LA的反流性食管炎患者的阻抗基线差异.结果 反流性食管炎组的阻抗基线值为（1 676.72±644.41）Ω,低于健康对照组的（2 151.27±322.05）Ω,差异有统计学意义（t=-3.883,P＜0.01）.食管AET与反流性食管炎患者的阻抗基线之间呈负线性相关（r=-0.530,P＜0.01）.LA-A级反流性食管炎患者的阻抗基线值为1 823.62 Ω（1 515.38 Ω,2 208.38 Ω）,LA-B级反流性食管炎患者的阻抗基线值为1 771.81 Ω（1 304.75 Ω,2 080.50 Ω）,差异无统计学意义（Z=-0.630,P=0.529）.LA-C/D级反流性食管炎患者的阻抗基线值为300 Ω（300 Ω,500 Ω）,明显低于LA-A级组和LA-B级组（Z=-2.647,-2.818;P均＜0.017）.结论 反流性食管炎患者的阻抗基线值降低,且与食管酸暴露程度相关.

Objective To investigate the changes of esophageal intraluminal baseline impedance in patients with refluxesophagitis.Methods From December 2013 to August 2014,47 patients with reflux esophagitis and 17 healthy controls were enrolled.The patients with reflux esophagitis were graded according to Los Angeles classification （LA） grading standards.All subjects accepted 24 h multichannel intraluminal impedance （MII） pH examination,and the baseline value of impedance were measured.Independent sample t test was used to compare the difference in impedance between the two groups.Spearman rank correlation coefficient was performed to analyze the correlation between acid exposure time （AET） and the baseline impedance of patients with reflux esophagitis.Kruskal-Wallis test was used to compare the differences in baseline impedance of patients with different grades of reflux esophagitis.Results The impedance baseline value of reflux esophagitis group was （1 676.72±644.41） Ω,which was lower than that of healthy control group （（2 151.27± 322.05） Ω）,and the difference was statistically significant （t =-3.883,P＜0.01）.The AET of esophagus was negatively correlated with the baseline impedance of the patients with reflux esophagitis （r=-0.530,P＜0.01）.The baseline impedance of patients with grade LA-A and grade LA-B reflux esophagitis were 1 823.62 Ω （1 515.38 52 Ω,2 208.38 Ω） and 1 771.81 Ω（1 304.75 52 Ω,2 080.50 Ω）,respectively,and the difference was not statistically significant （Z=-0.630,P=0.529）.The baseline impedance of patients with grade LA C/D reflux esophagitis was 300 Ω （300 Ω,500 Ω）,which was obviously lower than those of patients with grade LA-A or grade LA-B （Z=-2.647 and-2.818,both P＜0.017）.Conclusion The baseline impedance of patients with reflux esophagitis is low and correlated with AET.