LES的临床意义.docVIP

食管下括约肌长度测定的临床意义北京医科大学学报 1999年第1期第31卷 论著作者：邹　磊　蒋　绚　赵景涛单位：北京医科大学人民医院消化内科，北京　100044关键词：食管胃接合处；解剖学和组织学；胃食管反流；病理学；压力　　摘　要　目的:明确食管及其下括约肌长度在胃食管反流疾病中的变化及临床意义。方法：用灌注式多导测压系统对正常组63例受试者及胃食管反流组53例病人进行食管压力测定。结果:正常人各年龄组食管下段括约肌长度差异无显著性;胃食管反流性疾病组食管下段括约肌长度及腹段下括约肌长度均显著下降；正常组与胃食管反流性疾病组身高与食管长度的相关系数分别为r1=0.700，r2=0.798。结论:食管下括约肌长度在抗反流中起到重要作用，其在正常人群中不随年龄而变化；胃食管反流性疾病患者未伴食管长度缩短、上提。 　　中国图书资料分类法分类号　R573Clinical study on measurement of length of lower esophageal sphincter　　ZOU Lei， JIANG Xuan， ZHAO Jing-Tao　　(Department of Gastroenterology, Peoples Hospital, Beijing Medical University, Beijing　100044)　　MeSH　Esophagogastric junction/anat　　Gastroesophageal reflux/pathol　　Pressure　　ABSTRACT　Objective: To investigate the changes of esophageal and lower esophageal sphincter length in gastroesophageal reflux disease (GERD).Methods: PC Polygraf system was used to measure esophageal intraluminal pressure on 63 normal cases and 53 GERD cases with four channel tube assembly.Results: In normal cases the length of lower esophageal sphincter in different age groups had no significant difference. In GERD group the length of lower esophageal sphincter and intra abdominal sphincter obviously decreased. The related coefficient between esophageal length and body length in normal and GERD groups was 0.700 and 0.798， respectively.Conclusion: The length of lower esophageal sphincter was important in anti-reflux; it did not change with ages in normal group; GERD did not induce shortening of length of esophagus.(J Beijing Med Univ, 1999,31:90-92)　　胃食管反流性疾病（gastroesophageal reflux disease, GERD）被认为是运动障碍性疾病，其发病与食管下括约肌(lower esophageal sphincter, LES)功能降低，食管体廓清作用减弱密切相关，与食管下括约肌长度也有一定关系，因为维持一定长度是保证括约肌功能完整的一个客观条件。有动物实验认为酸异常反流至食管能导致其长度缩短，从而推测GERD为食管裂孔疝致病因素之一。为了明确食管长度及其下括约肌长度在GERD中的变化,进一步了解GERD的发病影响因素，本组实验用食管测压方法对正常受试者及GERD患者进行了对照研究。　　1　对象与方法　　1.1　对象　　正常受试者系我院学生及工作人员，共63 例，其中男性34例，女性29例；年龄22～67岁，平均40岁；无食管及影响食管功能的胃肠道与系统性疾病；无胃肠手术史。GERD组患者53例，男性24例，女性29例；年龄24～76岁，平均45岁；均为一年来在我科门诊就诊及病房住院病人；有烧心、反酸、反食等症状，病史在半年以上，