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目的探讨老年反流性食管炎(reflux esophagitis,RE)患者的食管运动功能特点,为老年RE患者的个体化治疗提供理论依据。方法回顾性分析经内镜诊断并行食管测压及(或)食管24 h p H值动态监测的老年RE患者77例与同期检出的中青年RE患者84例,分析2组患者的内镜分级及食管运动功能特点。结果老年组中重度食管炎所占比重明显高于中青年组(P<0.05)。老年组下食管括约肌压力(Lower esophageal sphincter pressure,LESP)、食管体部压力明显低于中青年组(P<0.05),老年组无效食管运动(ineffective esphageal motility,IEM)检出率明显高于中青年组(P<0.05)。老年组立位pH<4时间%、卧位pH<4时间%、pH<4总时间%、反流>5 min次数、最长反流持续时间、DeMeester评分明显高于中青年组(P<0.05),病理性酸反流检出率明显高于中青年组(P<0.05)。结论 RE食管黏膜破损程度老年人重于中青年人。老年RE患者抗反流能力减弱、食管酸廓清能力下降严重,出现更明显的食管运动功能障碍。
Objective To investigate esophageal motor function in elderly patients with reflux esophagitis (RE) and provide a theoretical basis for individualized treatment of elderly patients with RE. Methods Retrospective analysis of 77 elderly RE patients and 84 young and middle-aged RE patients detected by endoscopic diagnosis of esophageal variceal and / or esophageal 24 hp H values were retrospectively analyzed. Endoscopic classification and Esophageal motor function features. Results The proportion of moderate-to-severe esophagitis in the elderly group was significantly higher than that in the middle-aged group (P <0.05). Lower esophageal sphincter pressure (LESP) and pressure in the esophagus in the elderly group were significantly lower than those in the middle-aged and young adults (P <0.05). The detection rate of ineffective esophageal motility (IEM) in the elderly group was significantly higher than that in the middle Youth group (P <0.05). The elderly group set the position of pH <4% of time, lying pH <4% of time, pH <4% of the total time, reflux> 5 minutes, the longest duration of reflux, DeMeester score was significantly higher than the young group (P < 0.05). The detection rate of pathological acid reflux was significantly higher than that of middle-aged group (P <0.05). Conclusion The degree of esophageal mucosal damage in RE is higher than that in middle-aged and young people. Antidepressants in elderly patients with weakened anti-reflux, esophageal acid clearance decreased significantly, there is more obvious dysfunction of esophageal motility.