PDF(Pubmed)
Abstract：
OBJECTIVE: To investigate the esophageal motility characteristics of gastroesophageal reflux disease (GERD) and their relationship with symptoms.
METHODS: We examined 101 patients diagnosed with GERD by endoscopy and divided them into 3 groups as follows: nonerosive reflux disease (NERD), reflux esophagitis, and Barrett esophagus. Esophageal high-resolution manometry and the GERD Questionnaire were used to investigate the characteristics of esophageal dynamics and symptoms. In addition, the reflux symptom index was completed and the patients were divided into 7 groups according to symptoms. We then determined the correlation between dynamic esophageal characteristics and clinical symptoms.
RESULTS: Upper (UES) and lower (LES) esophageal sphincter pressures and the 4-second integrated relaxation pressure in the RE group were lower than those in the NERD group. The 4-second integrated relaxation pressure in the Barrett esophagus group was also lower than that in the NERD group. In the analysis of extraesophageal symptoms, high-resolution manometry showed significant differences in UES pressures among all groups. Further subgroup analysis showed that compared with the group without extraesophageal symptoms, the UES pressure of the groups with pharyngeal foreign body sensation, throat clearing, and multiple extraesophageal symptoms was lower.
CONCLUSIONS: As GERD severity increases, motor dysfunction of the LES and esophageal body gradually worsens, and the LES plays an important role in GERD development. Decreased UES pressure plays an important role in the occurrence of extraesophageal symptoms, which is more noticeable in patients with pharyngeal foreign body sensation and throat clearing.
METHODS: We examined 101 patients diagnosed with GERD by endoscopy and divided them into 3 groups as follows: nonerosive reflux disease (NERD), reflux esophagitis, and Barrett esophagus. Esophageal high-resolution manometry and the GERD Questionnaire were used to investigate the characteristics of esophageal dynamics and symptoms. In addition, the reflux symptom index was completed and the patients were divided into 7 groups according to symptoms. We then determined the correlation between dynamic esophageal characteristics and clinical symptoms.
RESULTS: Upper (UES) and lower (LES) esophageal sphincter pressures and the 4-second integrated relaxation pressure in the RE group were lower than those in the NERD group. The 4-second integrated relaxation pressure in the Barrett esophagus group was also lower than that in the NERD group. In the analysis of extraesophageal symptoms, high-resolution manometry showed significant differences in UES pressures among all groups. Further subgroup analysis showed that compared with the group without extraesophageal symptoms, the UES pressure of the groups with pharyngeal foreign body sensation, throat clearing, and multiple extraesophageal symptoms was lower.
CONCLUSIONS: As GERD severity increases, motor dysfunction of the LES and esophageal body gradually worsens, and the LES plays an important role in GERD development. Decreased UES pressure plays an important role in the occurrence of extraesophageal symptoms, which is more noticeable in patients with pharyngeal foreign body sensation and throat clearing.
摘要：
目的：探讨胃食管反流病(GERD)患者的食管动力特征及其与临床症状的关系。
方法：我们检查了101例经内镜诊断为GERD的患者，并将其分为以下3组：非糜烂性反流病（NERD），反流性食管炎,还有Barrett食道.采用高分辨率食管测压和GERD问卷对食管动力学和症状进行调查。此外,完成反流症状指数，根据症状分为7组。然后，我们确定了动态食管特征与临床症状之间的相关性。
结果：RE组上（UES）和下（LES）食管括约肌压力和4秒整合松弛压力低于NERD组。Barrett食管组的4秒整合松弛压也低于NERD组。在分析食管外症状时,高分辨率测压显示所有组的UES压力存在显著差异.进一步亚组分析显示,与无食管外症状组相比,咽部异物感组的UES压力，清嗓子,多个食管外症状较低。
结论：随着GERD严重程度的增加，LES和食管体的运动功能障碍逐渐恶化，LES在GERD的发展中起着重要作用。UES压力降低在食管外症状的发生中起重要作用,这在咽部异物感和喉咙清除率患者中更为明显。
方法：我们检查了101例经内镜诊断为GERD的患者，并将其分为以下3组：非糜烂性反流病（NERD），反流性食管炎,还有Barrett食道.采用高分辨率食管测压和GERD问卷对食管动力学和症状进行调查。此外,完成反流症状指数，根据症状分为7组。然后，我们确定了动态食管特征与临床症状之间的相关性。
结果：RE组上（UES）和下（LES）食管括约肌压力和4秒整合松弛压力低于NERD组。Barrett食管组的4秒整合松弛压也低于NERD组。在分析食管外症状时,高分辨率测压显示所有组的UES压力存在显著差异.进一步亚组分析显示,与无食管外症状组相比,咽部异物感组的UES压力，清嗓子,多个食管外症状较低。
结论：随着GERD严重程度的增加，LES和食管体的运动功能障碍逐渐恶化，LES在GERD的发展中起着重要作用。UES压力降低在食管外症状的发生中起重要作用,这在咽部异物感和喉咙清除率患者中更为明显。
