55例非梗阻性吞咽困难患者的高分辨率食管测压特征和精神心理特征分析

Analysis of high resolution esophageal manometry and psychological characteristics in 55 patients with non-obstructive dysphasia

[目的]探讨非梗阻性吞咽困难(NOD)患者的常见病因和食管动力特点及精神心理特征。[方法]利用高分辨率食管测压装置对55例NOD患者(NOD组)的食管动力特征进行采样和分析,并利用汉密尔顿焦虑量表(HAMA)与抑郁量表(HAMD)比较分析NOD患者和健康对照者(对照组,n=55)的精神心理状态。[结果]NOD组中非特异性食管动力障碍(NEMD)者、贲门失弛缓者、无效食管动力者食管下括约肌静息压(LESP)分别为(18.73±10.09)、(30.91±19.56)、(13.58±7.33)mmHg,食管上括约肌(UES)残余压分别为(14.08±4.35)、(20.12±7.52)、(13.84±5.02)mmHg,完整松弛压(IRP)分别为(9.78±4.46)、(22.06±9.88)、(8.10±4.07)mmHg,远端收缩积分(DCI)分别为2381.23±911.75、2443.87±662.29、699.35±244.81,NOD组各者之间均差异有统计学意义(P<0.05)。NOD组与对照组HAMA评分分别为(22.08±3.13)分、(8.05±2.75)分;HAMD评分分别为(23.49±5.13)分、(9.15±3.08)分;2组之间差异有统计学意义(P<0.05)。[结论]高分辨率食管测压可以对NOD患者的食管动力特征进行精确的分析,有助于对NOD的诊断和明确病因;且精神心理因素可能参与了NOD发生发展。

[Objective]To investigate the common etiology and esophageal motility of patients with non-obstructive dysphasia(NOD),and their psychological characteristics.[Methods]The esophageal motility characteristics of 55 patients with NOD were sampled and analyzed by high resolution manometry(HRM).The psychological characteristics of the patients were investigated by Hamilton Anxiety Scale(HAMA)and DepressionsScale(HAMD).[Results]The LESP of non-specific esophageal motility disorder(NEMD)group,achalasia group and ineffective esophageal motility group were(18.73 ± 10.09)mmHg,(30.91 ± 19.56)mmHg,(13.58 ± 7.33)mmHg.The residual UES pressure were(14.08±4.35)mmHg,(20.12±7.52)mmHg,(13.84±5.02)mmHg,and the integrated relaxation pressure(IRP)were(9.78 ± 4.46)mmHg,(22.06±9.88)mmHg,(8.10 ± 4.07)mmHg,and the distal contractile integral(DCI)were 2381.23±911.75,2443.87±662.29,699.35±244.81 respectively.The differences among the three groups were statistically significant(P< 0.05).The HAMA score of NOD group and control group were 22.08±3.13,8.05±2.75,respectively,and the HAMD score were 23.49±5.13,9.15±3.08,respectively.There was a significant difference between the two groups(P<0.05).[Conclusion]HRM can accurately analyze the esophageal motility characteristics of patients with NOD,which is helpful for the diagnosis and classification of NOD.Moreover,psychological factors may play a role in NOD.