Analysis Of Esophageal Motility Between Patients With Non-erosive Reflux Disease With Normal PH And Those With Abnormal PH By Using High Resolution Manometry

Objective：High resolution manometry(HRM) represents a greater improvement thanthe traditional manometry tools, which is gradually widely used in the esophagealmotility research. Lots of previous studies analyzed non-erosive reflux disease(NERD)as a whole. In our research, NERD patients were divided into normal and abnormal pHgroups according to the DeMeester score. To compare the characteristics ofesophageal motility between patients with non-erosive reflux disease with normal pHand those with abnormal pH by high resolution manometry.Methods：From August2011to December2012, a total of35NERD patients withheart burn, chest pain, anti-acids and other typical gastroesophageal reflux symptoms,whose score of reflux diagnosis questionnaire(RDQ)>12were enrolled inexperimental group. Each individual was evaluated with upper gastrointestinalendoscopy,24-hour esophageal pH monitoring. NERD patients were divided into normalpH group (n=20) and abnormal pH group (n=15), according to the DeMeester score, who wereconducted high resolution manometry. Lower esophageal sphincter length(LESL), loweresophageal sphincter pressure(LESP), distal esophageal contraction amplitude, distalcontractile integral(DCI) and effective peristalsis proportion were recorded. Healthyindividuals as control group, for a total of12cases, and concurrent esophagealmanometry and record the data. We used statistical analysis to compare thecharacteristics of esophageal motility of3groups and got the conclusion. Results：1、Comparison of lower esophageal sphincter(LES) function in NERDpatients:(1) Among the three groups, LESL and LESP were not exactly the same, thedifference was statistically significant(P<0.01);(2) pH(+)NERD patients had shorterLESL(2.8±0.3cm) than control group (3.7±0.5cm) and pH (－)NERD group (3.4±0.6cm), respectively(P<0.01);(3) pH(+)NERD patients had lower LESP(14.3±4.7mmHg,1mmHg＝0.133kPa) than control group (23.7±5.6mmHg) and pH(－)NERD group (22.1±6.8mmHg), respectively(P<0.01);(4) LESL and LESPdifferences between control group and pH (－)NERD group were not statisticallysignificant(P>0.05).2、Comparison of esophageal body motor function:(1) Among the three groups, distalesophageal contraction amplitude, DCI and effective peristalsis proportion were notexactly the same, the difference was statistically significant(P<0.01);(2) The distalesophageal contraction amplitude and DCI in pH (+)NERD group were (44.0±11.6mmHg) and (925.9±256.6mmHg.cm.s), and (53.1±15.5mmHg) and (1135.6±317.2mmHg.cm.s) in pH (－)NERD group.They were lower than control group (67.0±11.9mmHg) and (1460.1±386.9mmHg.cm.s)(P<0.05), pH (+)NERD groupreduced more obvious;(3) pH (+)NERD and pH (－)NERD patients had fewereffective peristalsis proportion (66.7±20.9%and77.0±13.4%) than control group(93.1±8.2%)(P<0.05), pH (+)NERD group reduced more obvious;(4) Theseparameters’ differences between pH (+)NERD and pH (－)NERD group were notstatistically significant(P>0.05).Conclusion：Different esophageal motility characteristics were found in differentNERD subgroups. Reduced LES length and pressure and more prominent distalesophageal motility disorders were seen in abnormal pH group of NERD.