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目的 探讨一氧化氮(NO)在糖尿病患者食管动力功能紊乱中的作用。 方法 应用PC polygraf HR高分辨多通道测压系统检测糖尿病患者的食管下括约肌压力(LESP)、食管下括约肌长度(LESL)及食管远端蠕动幅度等动力参数;应用Digitrapper MKⅢ动态pH监测仪检测其24h食管内pH各项参数;此外,血清NO含量也被检测。 结果 糖尿病组LESP,LESL均明显低于正常对照组(1.2kPa±0.08kPa vs 2.5kPa±0.3kPa;2.8cm±0.8cm vs 3.5cm±0.6cm,P<0.01,P<0.05),而多峰波及同步收缩波的病理性蠕动发生率则显著高于正常对照组(57.1％ vs 8.3％;21.4％ vs 8.3％,均P<0.01);糖尿病组的食管内24h pH值明显高于正常对照组,糖尿病组血清NO含量显著高于正常对照组(99.3μmol/L±21.4μmol/L vs 76.6μmol/L±18.7μmol/L,P<0.01)。 结论 2型糖尿病患者食管蠕动异常,食管内酸度增加。一氧化氮可能参与糖尿病食管运动功能障碍的发病机制。
Objective To investigate the role of nitric oxide (NO) in the dynamic disturbance of esophageal motility in diabetic patients. Methods PC polygraf HR high-resolution multi-channel manometry system was used to detect dynamic parameters of lower esophageal sphincter pressure (LESP), lower esophageal sphincter length (LESL) and distal esophageal peristalsis amplitude. Digitrapper MKⅢ dynamic pH monitor 24h esophageal pH parameters; In addition, serum NO levels were also tested. Results LESP and LESL in diabetic group were significantly lower than those in normal control group (1.2kPa ± 0.08kPa vs 2.5kPa ± 0.3kPa; 2.8cm ± 0.8cm vs 3.5cm ± 0.6cm, P <0.01, P <0.05) The incidence of pathological peristalsis in synchronized contractile wave was significantly higher than that in normal control group (57.1% vs 8.3%; 21.4% vs 8.3%, all P <0.01). The intra-esophageal 24h pH value in diabetic group was significantly higher than that in normal control group , And the serum NO level in diabetic group was significantly higher than that in the normal control group (99.3μmol / L ± 21.4μmol / L vs 76.6μmol / L ± 18.7μmol / L, P <0.01). Conclusion Patients with type 2 diabetes have abnormal esophageal motility and increased esophageal acidity. Nitric oxide may be involved in the pathogenesis of diabetic esophageal dysfunction.