The Research On The Applications Of High Resolution Esophageal Manometry In Gastroesophageal Reflux Disease

Objective: The patients with gastroesophageal reflux disease(GERD) were determined using high-resolution manometry(HRM) and we analyzed the result of esophageal motility parameters. Explore the esophageal motility features and pathogenesis of patients with GERD.Methods: 76 patients with GRED were randomly selected, including reflux esophagitis(RE; n=40) and nonerosive reflux disease(NERD; n=36) and also healthy controls with no digestive symptoms(n=36), were studied by high resolution manometry. Record the parameters of upper and lower esophageal sphincter and esophageal body and compare their difference in each group.Results: 1. Both the lower esophageal sphincter length(LESL) and lower esophageal sphincter pressure(LESP) decreased in RE group and NERD group in comparison of control group, the difference was statistically significant(P<0.01), and the differences in RE group were more significant than NERD group(P<0.05); 4 seconds integrated relaxation pressure(4s IRP) in RE group and NERD group was lower than control group, the difference was statistically significant(P<0.01), and the differences in RE group were more significant than NERD group(P<0.05). 2. Both the times of transient lower esophageal sphincter relaxations in per hour and the single relaxation time increased in RE group and NERD group in comparison of control group, the difference was statistically significant(P<0.01), and the differences in RE group were more significant than NERD group(P<0.05). 3. The upper esophageal sphincter length(UESL) and the upper esophageal sphincter pressure(UESP) in RE group and NERD group had no significantdifferences in comparison of control group(P>0.05), and the difference was not statistically significant between RE group and NERD group(P> 0.05). 4. The DCI and CFV of esophageal body in both RE group and NERD group were lower than the control group, the difference was statistically significant(P<0.01), and the differences in RE group were more significant than NERD group with P<0.05; the PB and DL in both RE group and NERD group were higher than the control group, the difference was statistically significant(P<0.01), and the differences in RE group were more significant than NERD group(P<0.05).Conclusion: 1. Reduction of anti-reflux function of lower esophageal sphincter may be the important pathogenesis of GERD. 2. The transient lower esophageal sphincter relaxation may be the important pathogenesis of GERD. 3. The upper esophageal sphincter function may have no relationship with GERD. 4. The esophageal body motility dysfunction may be the important pathogenesis of GERD.