| Background:Reflux esophagitis (RE) is one of the most common esophageal movement disorder diseases. It influences patients’ life because of the acid reflux, heartburn and retrosternal pain, and its morbidity is increasing in recent years. Progressively severe mucosal injury may lead to events like the Barrett esophagus, which may develop into esophagus cancer. For the past few year, studies in the pathogenesis and treatment have increased, while few focus on the High-resolution manometry (HRM) of RE. HRM can describe the outline of the esophageal movement disorder, and help to determine the function of esophageal body, upper esophageal sphincter (UES), lower esophageal sphincter (LES) and oropharynx.Purpose:To investigate the features of esophageal motility and lower esophageal sphincter (LES) pressure by using High-resolution manometry (HRM) in patients with reflux esophagitis.Methods:RE patients diagnosed by the endoscopic examination were divided into two groups (the light group and the severe group) according to Los Angeles System. They took the esophageal manometry as well as health people. The data were analyzed by statistical method.Results:1. The UES resting pressure and integrated relaxation pressure of RE group was basically normal compared with the normal control group. UES Relaxes completely and cooperates with oropharynx well.2. The LES resting pressure of severe RE group was decreased compared of the control group (4.1±1.36mmHg vs.6.92±4.48mmHg P<0.05). There is no difference between the light RE group and the control group or the severe group (5.20±1.90mmHg vs.6.92±4.48mmHg P>0.05;5.20±1.90mmHg vs.4.19±1.36mmHg P>0.05). The LRP4s of both RE groups was decreased (4.22±2.10mmHg vs.8.56+6.60mmHg P<0.05;4.5±3.09mmHg vs.8.56±6.60mmHg P<0.05), while no difference was found between two RE groups. The LESL was decreased in severe RE group compared of the light group or control group (P<0.05), and there is no difference between the light group and control group.3. The distal contractile Integral (DCI) was decreased in severe group between the control group and the light group (334.93±268.66mmHg.s.cm vs.989.30±439.91mmHg.s.cm P<0.01;334.93±268.66mmHg.s.cm vs.732.0±191.71mmHg.s.cm P <0.01). The contractile front velocity (CFV) among three groups was Basically the same. Distal Latency (DL) in severe RE groups were higher than in the normal control group (7.09±0.97s vs.5.79±0.82s P<0.01), and higher than in the light group (7.09±0.97s vs.6.22±0.63s P<0.05).4. The esophageal motility function of RE group was worse than the control group. The ratio of slowed and failed peristalsis was much higher in the severe group than in the light group.Conclusions:1. High-resolution manometry could describe exactly in the UES pressure, LES pressure and the function of the esophagus, compared of the traditional esophageal manometry. It is more convenient in operating and analyzing data. 2. The function of the proximal esophageal has not been significantly impaired in RE patients. Dysfunction is mainly manifested in the distal esophagus and stomach esophagus connection.3. The debility of LES in RE patients was mainly reflected in the decrease of LES rest pressure and the weakness of the anti-reflux mechanism.4. The poor peristalsis of the distal esophagus in RE patients leads to the disorder of anti-reflux mechanism and may play an important role in its pathogenesis.5. There are more obvious abnormal esophageal dynamics in the severe RE group than the light group.6. As a result of the decrease of the LES pressure and the function of esophageal motility function, gastric and duodenal reflux in esophageal strands and esophageal acid, alkali exposure prolongs, leads to esophageal mucosa injury easily. |
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