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目的研究非糜烂性反流病(NERD)患者食管腔内气囊扩张刺激-脑诱发电位(ED-CEP)的特征及其食管黏膜中降钙素基因相关肽(CGRP)、P物质(SP)表达的改变,探讨NERD内脏高敏的机制。方法收集第二军医大学长海医院消化内科2004-10—2005-03NERD患者26例和健康对照者12名,采用ED-CEP技术记录分析CEP的变化,并观察远端食管黏膜组织中CGRP、SP免疫反应阳性产物的分布和表达。结果NERD患者CEP波形变异性大,其N1、P1、N2波潜伏期明显缩短(P<0·05),CEP的P1-N2峰间波幅也明显增加[(7·8±3·2)μV对(6·2±1·9)μV,P=0·03]。其远端食管黏膜的CGRP、SP阳性产物OD值分别较对照组升高[(0·46±0·16)对(0·23±0·10),(0·42±0·12)对(0·29±0·05)](P<0·05)。结论NERD患者ED-CEP和食管黏膜中CGRP、SP的表达与对照组存在差异,提示NERD患者的食管-中枢内脏感觉传导通路存在一定的异常改变。
Objective To investigate the characteristics of airway dilatation-evoked potentials (ED-CEP) and calcitonin gene related peptide (CGRP), substance P (SP) in esophageal mucosa of non-erosive reflux disease (NERD) Expression changes, to explore the mechanism of visceral hypersensitivity NERD. Methods Twenty-six patients with NAFD and 12 healthy controls from Department of Gastroenterology, Changhai Hospital, Second Military Medical University from 2004 to 2005 were enrolled in this study. The changes of CEP were recorded by ED-CEP and the expressions of CGRP and SP in distal esophageal mucosa The distribution and expression of reaction-positive products. Results The waveform of CEP in NERD patients was large and the latency of N1, P1 and N2 waves was significantly shortened (P <0.05). The amplitude of CEP between P1 and N2 peaks also increased significantly [(7.8 ± 3.2) μV (6 · 2 ± 1 · 9) μV, P = 0 · 03]. The distal esophageal mucosa CGRP, SP positive product OD values ?? were higher than the control group [(0.46 ± 0.16) vs (0 · 23 ± 0 · 10), (0.42 ± 0.12) pairs (0.29 ± 0.05)] (P <0.05). Conclusions There is a difference between ED-CEP and esophageal mucosa between NERD patients and control group, suggesting that there is some abnormal change in esophageal-central visceral sensory pathway in patients with NERD.