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目的:探讨24h食管pH监测及食管下端括约肌压力(loweresophagealsphincterpressure,LESP)测定在新生儿胃食管反流(gastroesophagealreflux,GER)中的应用和临床意义。方法:对30例疑诊为GER的新生儿行24h食管pH监测,其中15例测定LESP。结果:30例GER中22例(73%)为病理性,8例为生理性;病理性GER组的LESP犤(2.18±0.32kPa)犦及屏障压犤(1.48±0.71kPa)犦显著低于生理性GER组犤分别为(2.71±0.39)kPa、(2.66±0.17)kPa犦,均为P<0.05;综合评分、pH小于4的总百分率时间分别与LESP、屏障压呈负相关(相关系数分别为r=-0.618,r=-0.595,r=-0.327,r=-0.408,均为P<0.05)。结论:无创性24h食管pH监测及LESP测定是研究新生儿胃肠动力学的好方法,使新生儿GER得以及早诊断,LESP及屏障压降低是新生儿病理性GER的病理生理基础。
Objective: To investigate the application and clinical significance of 24-hour esophageal pH monitoring and loweresophagealphincterpressure (LESP) measurement in gastroesophageal reflux (GER). Methods: Thirty cases of suspected neonates with GER were monitored for esophageal pH 24 hrs, and 15 of them were tested for LESP. RESULTS: Twenty-two of 30 (73%) GERs were histopathologically and 8 were pathologically physiologically. LESP 犦 (2.18 ± 0.32 kPa) 屏 and barrier pressure 犤 (1.48 ± 0.71 kPa) 病 in pathological GER were significantly lower than Physiological GER were (2.71 ± 0.39) kPa and (2.66 ± 0.17) kPa 犦, respectively, all P <0.05. The total score, the total percentage of pH less than 4 were negatively correlated with LESP and barrier pressure respectively (correlation coefficient Respectively, r = -0.618, r = -0.595, r = -0.327, r = -0.408, all P <0.05). CONCLUSION: Noninvasive 24-hour esophageal pH monitoring and LESP determination are good methods for studying gastrointestinal motility in newborns. Early neonatal GER can be diagnosed, and LESP and barrier pressure drop are the pathophysiological basis of neonatal pathological GER.