反流性食管炎患者血浆胃动素、胃排空时间相关性研究

Correlation between plasma motilin and gastric emptying time in patients with reflux esophagitis

目的 测定反流性食管炎患者血浆胃动素浓度、胃排空时间和下食管括约肌压力 (LESP) ,以探讨这些因素与反流性食管炎发病机制之间的关系。方法 研究对象为 2 8例反流性食管炎患者及 2 0例正常对照。食管内压测定应用PCPolygraphHR台式高分辨上消化道动力监测系统 ,采用放射免疫法测定血浆胃动素浓度 ,胃排空检测应用TOSHIBA 2 4 0A型B超。结果 病例组血浆胃动素浓度 (2 2 8.6 0± 99.0 2 )ng/L ,与对照组相比差异有统计学意义 (P <0 .0 5 )。LESP与血浆胃动素浓度呈明显正相关关系 (r=0 .739,P <0 .0 1)。病例组胃排空时间 (114 .79±18.4 5 )min ,与对照组相比差异有统计学意义 (P <0 .0 1)。血浆胃动素浓度与胃排空时间呈明显正相关关系 (r =0 .5 37,P <0 .0 1)。而胃排空时间与LESP无相关性 (r=0 .0 32 ,P >0 .0 5 )。结论 反流性食管炎患者存在血浆胃动素水平降低和胃排空时间延长 ,胃动素降低可降低LESP ,而胃排空时间延长对LESP无影响。

Objective To measure the plasma concentration of motilin, the gastric emptying time and the lower esophageal sphincter pressure (LESP) in patients with reflux esophagitis (RE) in order to evaluate the relationship between these factors and RE. Methods LESP was determined by digestive fract manometry instrument in 28 cases of RE and 20 cases of normal control. Plasma concentration of motilin was determined by radioimmunoassay technique. Gastric emptying time was determined with ultrasonography. Results The mean plasma concentration of motilin in 28 cases was ( 228.60 ± 99.02 ) ng/L, and significantly lower than that in control (P< 0.05 ). There was a significant positive correlation between LESP and motilin plasma level (r= 0.739 , P< 0.01 ). The mean gastric emptying time in 28 cases was ( 114.79 ± 18.45 ) min, and significantly longer than that in control (P< 0.01 ). There was a significant positive correlation between the motilin plasma level and the gastric emptying time (r= 0.537 , P< 0.01 ) There was no correlation between LESP and gastric emptying time(r= 0.032 , P> 0.05 ). Conclusion The cases with RE have lower plasma motilin level and longer gastric emptying time. The lower plasma motilin level may reduce LESP,but longer gastric emptying time has little effect on LESP.