24h pH-阻抗监测研究非糜烂性反流病、糜烂性食管炎及幽门螺杆菌的关系

24 hours pH-impedance monitoring research non erosive reflux disease,erosive esophagitis,and the relationship between helicobacter pylori

目的观察24 h pH-阻抗监测研究非糜烂性反流病(NERD)及糜烂性食管炎(EE)反流物的特点及与幽门螺杆菌(Hp)的关系。方法选取EE组24例和NERD组23例,给予受试者行^(13)C呼气试验行高分辨率食道测压检查,最后行食道pH-阻抗检查,需监测指标有下食管括约肌压力(LESP)、长度(LESL)及上食管括约肌压力(UESP)、食管收缩波幅,酸、弱酸、弱碱反流次数、长反流次数、总反流次数。结果高分辨率食道测压监测NERD组的食管收缩波幅显著高于EE组,差异有统计学意义(P<0.05)。食道pH-阻抗监测EE组的酸反流次数及弱酸反流次数较NERD组显著增多(P<0.05);EE组长反流次数、总反流次数较NERD组增多(P<0.05)。各组间监测LESP、LESL及UESP、弱碱反流次数,差异均无统计学意义(P>0.05)。结论 24 h pH-阻抗监测技术对了解EE及NERD发病机制、特点有重要影响。

Objective To observe the 24-hour p H-impedance monitoring to investigate the relationship between non erosive reflux disease（NERD）,erosive esophagitis（EE） and helicobacter pylori（Hp）. Methods 24 EE patients and 23 NERD patients were enrolled the trail. They were evaluated by ^（13） C breath test,high resolution esophageal pressure check and esophageal pH-impedance check. These index should be monitor：Lower esophageal sphincter pressure（LESP）,Lower esophageal sphincter length（LESL）, Higher esophageal sphincter pressure（UESP）,esophageal contraction amplitude,the number of acid reflux, the number of weak acid reflux,the number of weak base reflux,the number of longer re flux,the number of total reflux. Results Compared with EE group in high resolution esophageal pressure check, esophageal contraction amplitude was higher in NERD and there were significant differences（P〈0.05）. Compared with NERD group in pH-impedance monitoring, the number of acid reflux and acid reflux was higher in EE group（P〈0.05）.Compared with NERD group in pH-impedance monitoring,the number of longer reflux,and total reflux was higher in EE group（P〈0.05）;Other indicators such as LESP,LESL,UESP,the number of weak base reflux showed no significant differences between EE group and NERD group（P〉0.05）. Conclusion 24 hours p H-impedance monitoring have important influence on pathogenesis characteristics of EE and NERD.