Esophagogastric Junction Contractility Integral Reflect the Anti-reflux Barrier Dysfunction in Patients with Gastroesophageal Reflux Disease.
Esophagogastric Junction Contractility Integral Reflect the Anti-reflux Barrier Dysfunction in Patients with Gastroesophageal Reflux Disease.
复制标题
胃食管反流病患者食管胃结合部收缩力积分反映抗反流屏障功能障碍
DOI：
10.5056/jnm16008
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发表时间：
2017-01-30
影响因子：
3.4
通讯作者：
Xiao Y
中科院分区：
文献类型：
--
作者：
Xie C;Wang J;Li Y;Tan N;Cui Y;Chen M;Xiao Y
抗反流屏障功能障碍是胃食管反流病（GERD）发病的主要机制之一。食管胃交界处收缩积分（EGJ-CI）是评价EGJ收缩性的新指标，反映了抗反流屏障功能。本研究的目的是在GERD患者中验证这一新指标及其与食管酸暴露的相关性，以及质子泵抑制剂治疗的疗效。98名GERD患者和21名健康对照者被纳入研究。所有患者均行上消化道内镜检查、高分辨率测压（HRM）和24小时多通道腔内阻抗-pH监测。在初始HRM静息帧处选择三个呼吸周期，然后用远端收缩积分工具计算的值除以周期的持续时间以产生EGJ-CI。埃索美拉唑20 mg，每日2次，疗程8周。GERD组EGJ-CI低于对照组（P < 0.05）。食管裂孔疝组EGJ-CI低于GERD组（P < 0.05）。新指标与仰卧位食管酸暴露量相关（P < 0.05），与总反流次数呈负相关（P < 0.05）。埃索美拉唑治疗有效和无效患者的EGJ-CI无显著差异（P = 0.627）。EGJ-CI反映了GERD患者的抗反流屏障功能障碍，但对埃索美拉唑的疗效影响不大。
Anti-reflux barrier dysfunction is one of the primary mechanisms in gastroesophageal reflux disease (GERD) pathogenesis. The esophagogastric junction contractile integral (EGJ-CI) is a new metric adopted to evaluate the EGJ contractility, which implies the anti-reflux barrier function. The aim of the current study was to validate this new metric in patients with GERD and its correlation with the esophageal acid exposure, as well as the efficacy of proton pump inhibitor treatment. Ninety-eight patients with GERD and 21 healthy controls were included in the study. Upper endoscopy, high-resolution manometry (HRM) and 24-hour multichannel intraluminal impedance-pH monitoring were performed in all patients. Three respiration cycles were chosen at the initial HRM resting frame and the value computed with distal contractile integral tool was then divided by the duration of the cycles to yield EGJ-CI. All the patients were treated with esomeprazole 20 mg twice-daily for 8 weeks. EGJ-CI was lower in the patients with GERD than that of the controls (P < 0.05). For patients with GERD, EGJ-CI was lower in those with hiatal hernia (P < 0.05). The new metric correlated with esophageal acid exposure in the supine position (P < 0.05), and it also negatively correlated to the total reflux episodes (P < 0.05). There was no significant difference on EGJ-CI between patients with and without response to the esomeprazole treatment (P = 0.627). EGJ-CI reflected the dysfunction of the anti-reflux barrier in patients with GERD, but it had little impact on the esomeprazole response.
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影响因子：
3.5
作者：
Bredenoord AJ;Fox M;Kahrilas PJ;Pandolfino JE;Schwizer W;Smout AJ;International High Resolution Manometry Working Group
通讯作者：
International High Resolution Manometry Working Group
影响因子：
3.4
作者：
Wang YT;Yazaki E;Sifrim D
通讯作者：
Sifrim D
影响因子：
2.6
作者：
Khajanchee, Y. S.;Cassera, M. A.;Dunst, C. M.
通讯作者：
Dunst, C. M.
影响因子：
3.5
作者：
Nicodème F;Pipa-Muniz M;Khanna K;Kahrilas PJ;Pandolfino JE
通讯作者：
Pandolfino JE
影响因子：
3.5
作者：
Tolone, S.;De Bortoli, N.;Savarino, E.
通讯作者：
Savarino, E.