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为探讨肠易激综合征(IBS)患者的食管症状与其运动功能及病理变化之间的关系。对正常人、IBS 有症状和无症状者及非 IBS 的有食管症状者行上消化道内镜、病理检查、食管测压和食管24小时 pH 监测。结果:(1)IBS 患者食管内镜和病理检查异常者显著高于正常组和无症状组。(2)IBS 有症状组食管下段平滑肌压力(LESP)显著低于正常组和无症状 IBS 组;(3)两组 IBS 患者食管下段蠕动间期和传导速度显著高于正常组;并且存在着同步收缩、重复收缩等异常蠕动。(4)UES 压力在 IBS 患者无显著异常。(5)IBS有症状组 pH 总分、总暴酸时间百分比及最长暴酸时间均显著高于正常人和无症状 IBS者。结论:IBS 患者常合并食管症状。LES 压力降低,胃食管反流为这些症状产生的主要因素。
To investigate the relationship between esophageal symptoms and motor function and pathological changes in patients with irritable bowel syndrome (IBS). Upper gastrointestinal endoscopy, pathologic examination, esophageal manometry and esophageal 24-hour pH monitoring were performed on subjects with symptomatic and asymptomatic IBS and non-IBS with esophageal symptoms. Results: (1) Esophageal endoscopy and pathological abnormalities in IBS patients were significantly higher than those in normal group and asymptomatic group. (2) The lower esophageal smooth muscle pressure (LESP) in IBS symptomatic group was significantly lower than that in normal group and asymptomatic IBS group. (3) The lower esophageal stroke and conduction velocity were significantly higher in IBS patients than in normal group Contractions, repeated contraction and other abnormal peristalsis. (4) UES pressure in patients with IBS no significant abnormalities. (5) The total score of pH, the percentage of total acid exposure and the longest duration of acidosis in symptomatic IBS patients were significantly higher than those in normal subjects and asymptomatic IBS. Conclusions: IBS patients often have esophageal symptoms. LES pressure decreases, gastroesophageal reflux of these symptoms are the main factors.