摘要

本文研究了43例反流性食管炎患者治疗后对食管功能的影响。所有患者在食管炎完全愈合前后进行了食管测压和转运研究。食管炎给予奥美拉唑40 mg/天治疗，中位持续时间为12周。23名患者在愈合前后也进行了酸清除试验。43例患者中有38例在治疗前进行了24小时食管pH监测，其中31例在愈合后(服用奥美拉唑)重复监测。34名志愿者作为对照组。所有志愿者都进行了测压，33人进行了食管转运研究，23人进行了胃酸清除试验。与对照组相比，患者的下食管括约肌压力和远端和中端食管振幅显著降低，收缩持续时间更长，传播速度更慢(16.5 v 22.5 mm Hg;52 v 92毫米汞柱;46 v 79 mm Hg; 3.1 v 2.7 seconds; and 3.3 v 4.1 cm/second respectively with the corresponding p values = 0.017; 0.0001; 0.0001; 0.017; and 0.006). Patients had significantly longer transit times (9 v 7 and 17 v 11 seconds: p = 0.027 and 0.002 for erect and supine postures respectively). They also had longer acid clearance times (350 v 288 and 536 v 405 seconds: p = 0.044 and 0.016 for sitting and supine postures respectively). There was no significant change in any of the indices of oesophageal function after healing of oesophagitis (lower oesophageal sphincter pressure = 16.5 v 20; distal amplitude = 52 v 60; middle amplitude = 46 v 49; duration of contraction = 3.1 v 3.1; velocity = 3.3 v 3.3; erect transit time = 9 v 9; supine transit time = 17 v 24; acid clearance test (sitting) = 350 v 371; acid clearance test (supine) = 536 v 645). These results indicate that oesophageal motor dysfunction in reflux oesophagitis is a primary phenomenon.