切换至 "中华医学电子期刊资源库"
高级检索
中华诊断学电子杂志

中华诊断学电子杂志 ›› 2016, Vol. 04 ›› Issue (03) : 149 -152. doi: 10.3877/cma.j.issn.2095-655X.2016.03.002

所属专题： 文献；

消化系统疾病与心身医学观

难治性癔球症患者食管压力特征及血清脑肠肽水平的变化
刘尧1, 贾林2,†()   
  1. 1. 511400　广州医科大学附属广州市第一人民医院消化内科
    2. 511400　广州医科大学附属广州市第一人民医院消化内科；511457　广州市南沙中心医院消化内科
  • 收稿日期:2016-07-30 出版日期:2016-08-26
  • 通信作者: 贾林

The esophageal motility characteristics and levels of brain-gut peptide in patients with refractory globus

Yao Liu1, Lin Jia2,†()   

  1. 1. Department of Gastroenterology, Guangzhou First People′s Hospital, the Affiliated Hospital of Guangzhou Medical University, Guangzhou 511400, China
    2. Department of Gastroenterology, Guangzhou First People′s Hospital, the Affiliated Hospital of Guangzhou Medical University, Guangzhou 511400, China; Department of Gastroenterology, Guangzhou Nansha Central Hospital Affiliated to Guangzhou First People’s Hospital, Guangzhou 511457, China
  • Received:2016-07-30 Published:2016-08-26
  • Corresponding author: Lin Jia
  • About author:
    Corresponding author: Jia Lin, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

刘尧, 贾林. 难治性癔球症患者食管压力特征及血清脑肠肽水平的变化[J]. 中华诊断学电子杂志, 2016, 04(03): 149-152.

Yao Liu, Lin Jia. The esophageal motility characteristics and levels of brain-gut peptide in patients with refractory globus[J]. Chinese Journal of Diagnostics(Electronic Edition), 2016, 04(03): 149-152.

目的

探讨难治性癔球症(RG)与非难治性癔球症(NRG)患者食管运动功能尤其是食管上括约肌(UES)压力及血清脑肠肽水平的变化特征。

方法

采用高分辨食管测压系统(HRM)对癔球症患者行食管测压并留取空腹静脉血，检测血清脑肠肽水平，对比难治性癔球症患者和非难治性癔球症患者食管测压结果及血清脑肠肽水平差异。

结果

RG患者的UES静息压显著高于NRG患者[(94.97±42.08)mmHg，(73.91±23.47) mmHg，t＝2.359，P<0.05)](1 mmHg＝0.133 kPa)；RG患者与NRG患者UES残余压[(12.44±8.31)mmHg，(12.66±8.12)mmHg]、UES长度[(22.72±10.13)mm，(19.71±7.85)mm]、收缩前速度(CFV)[(5.47±1.39)cm/s，(5.24±1.40)cm/s]、收缩延迟时间(DL)[(6.59±1.29)s，(6.78±1.10)s]、食管下括约肌(LES)静息压[(22.63±10.17)mmHg，(19.56±7.63)mmHg]比较，均差异无统计学意义(t＝0.528，0.471，0.725，0.736，0.486；P>0.05)；NRG患者的血清神经肽Y(NPY)水平较RG患者低[(626.26±16.60)ng/L，(641.35±17.45)ng/L，t＝2.528，P<0.05]；RG患者血清P物质(SP)水平高于NRG患者[(2386.96±372.68)ng/L，(1607.77±345.91)ng/L，t＝3.728，P<0.05)]；NRG患者与RG患者两者血清中降钙素基因相关肽(CGRP)水平无统计学差异[(236.17±76.85)ng/L，(229.35±57.52)ng/L，t＝0.752，P>0.05)]。

结论

相对于NRG患者，RG患者具有更高的UES静息压和较高水平的血清P物质含量以及较低水平的血清神经肽Y含量。

关键词: 癔球症, 食管括约肌，上段, 降钙素基因相关肽, 神经肽Y, P物质
Objective

To compare the esophageal motility and the levels of brain-gut peptide between refractory globus patients and non-refractory globus patients.

Methods

All subjects underwent high-resolution manometry (HRM) and were detected the levels of brain-gut peptide, which were compared the differences between refractory globus patients and non-refractory globus patients.

Results

Refractory globus patients had higher upper esophageal sphincter (UES) resting press [(94.97±42.08)mmHg] compared with non-refractory globus patients [(73.91±23.47)mmHg, t=2.359, P<0.05]. There were no statistical differences in UES residual pressure[(12.44±8.31)mmHg, (12.66±8.12)mmHg], UES length[(22.72±10.13)mm, (19.71±7.85)mm], CFV[(5.47±1.39)cm/s, (5.24±1.40)cm/s], DL[(6.59±1.29)s, (6.78±1.10)s], LES[(22.63±10.17)mmHg, (19.56±7.63)mmHg] between refractory globus patients and non-refractory globus patients (t=0.528, 0.471, 0.725, 0.736, 0.486; P>0.05). The level of NPY was lower in refractory globus patients [(626.26±16.60)ng/L] than that in non-refractory globus patients [(641.35±17.45)ng/L (t=2.528, P<0.05)], but the level of SP was higher in refractory globus patients [(2386.96±372.68)ng/L] than that in non-refractory globus patients [(1607.77±345.91)ng/L], the difference was statistically different (t=3.728, P<0.05). And no statistical difference was found in calcitonin gene-related peptide (CGRP) between refractory globus patients and non-refractory globus patients (t=0.752, P>0.05).

Conclusion

Compared with non-refractory globus patients, refractory globus patients have higher UES resting pressure, higher level of SP and lower level of NPY.

Key words: Globus, Esophageal sphincter, upper, Calcitonin gene-related peptide, Neuropeptide Y, Substance P
表1 难治性癔球症患者与非难治性癔球症患者一般情况比较
组别 例数 性别(例，%) 年龄(岁，±s) 吸烟(例，%) 饮酒(例，%)
女 男 是 否 是 否
难治性癔球症 43 27(62.79) 16(37.21) 46.76±12.92 7(16.28) 36(83.72) 8(18.60) 35(81.40)
非难治性癔球症 77 48(62.34) 29(37.66) 44.94±13.07 13(16.88) 64(83.12) 15(19.48) 62(80.52)
统计量 ? χ2＝0.002 t＝1.593 χ2＝0.007 χ2＝0.014
P值 ? 0.961 0.497 0.932 0.907
表2 难治性癔球症与非难治性癔球症患者的食管测压结果(±s)
组别 例数 UES静息压(mmHg) UES残余压(mmHg) UES长度(mm) CFV(cm/s) DL(s) LES静息压(mmHg)
难治性癔球症 43 94.97±42.08 12.44±8.31 22.72±10.13 5.47±1.39 6.59±1.29 22.63±10.17
非难治性癔球症 77 73.91±23.47 12.66±8.12 19.71± 7.85 5.24±1.40 6.78±1.10 19.56± 7.63
t值 ? 2.359 0.528 0.471 0.725 0.736 0.486
P值 ? 0.010 0.897 0.130 0.440 0.426 0.103
表3 癔球症患者血清脑肠肽含量比较(ng/L，±s)
组别 例数 CGRP NPY SP
难治性癔球症 37 236.17±76.85 626.26±16.60 2386.90±372.68
非难治性癔球症 25 229.35±57.52 641.35±17.45 1607.00±345.91
t值 ? 0.752 2.528 3.728
P值 ? 0.692 0.001 0.001
[1]
Tang B,Jia L,Liu J, et al.Clinical-psychological characteristics of refractory globus patients in China[J]. Dig Liver Dis, 2016, 48(4): 381-384.
[2]
Galmiche JP,Clouse RE,Bálint A,et.al.Functional esophageal disorders[J]. Gastroenterology, 2006, 130(5): 1459-1465.
[3]
Thompson WG,Heaton KW.Heartburn and globus in apparently healthy people[J]. Can Med Assoc J, 1982, 126(1): 46-48.
[4]
Corso MJ,Pursnani KG,Mohiuddin MA, et al.Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal reflux[J]. Dig Dis Sci, 1998, 43(7): 1513-1517.
[5]
Halum SL,Butler SG,Koufman JA, et al.Treatment of globus by upper esophageal sphincter injection with botulinum A toxin[J]. Ear Nose Throat J, 2005, 84(2): 74.
[6]
朱元民,赵景涛,刘玉兰.87例咽异感症的临床研究[J]. 中国现代医学杂志, 2000, 10(3): 1-2.
[7]
陈军,徐洁洁,陈曦, 等. 咽异感症的喉镜观察和食管上括约肌压力检测[J]. 江苏医药, 2006, 32(8): 727-728.
[8]
Tokashiki R,Funato N,Suzuki M. Globus sensation and increased upper esophageal sphincter pressure with distal esophageal acid perfusion[J]. Eur Arch Otorhinolaryngol, 2010, 267(5): 737-741.
[9]
Sun J,Xu B,Yuan YZ, et al.Study on the function of pharynx upper esophageal sphincter in globus hystericus[J]. World J Gastroenterol, 2002, 8(5): 952-955.
[10]
许斌,孙菁,孙星梅, 等. 癔球症患者咽及食管上括约肌功能初步研究[J]. 中华消化杂志, 2002, 22(6): 370-371.
[11]
Choi WS,Kim TW,Kim JH, et al.High-resolution manometry and globus：comparison of globus, gastroesophageal reflux disease and normal controls using high-resolution manometry[J]. J Neurogastro enterol Motil, 2013, 19(4): 473-478.
[12]
Nevalainen P,Walamies M,Kruuna O, et al.Supragastric belch may be related to globus symptom-a prospective clinical study[J]. Neurogastroenterol Motil, 2016, 28(5): 680-686.
[13]
Mertz H,Naliboff B,Munakata J, et al.Altered rectal perception is a biological maker of patients with irritable bowel syndrome[J]. Gastroenterology, 1995, 109(1): 40-52.
[14]
曹建新. 整体医学模式下心身医学评估的临床实践[J/CD]. 中华诊断学电子杂志, 2015, 3(2): 128-132.
[15]
Chen CL,Szczensniak MM,Cook IJ. Evidence for oesophageal visceral hypersensitivity and aberrant symptom referral in parients with globus[J]. Neurogastroenterol Motil, 2009, 21(11): 1142-e96.
[16]
Mearin F. Postinfectious functional gastrointestinal disorders[J]. J Clin Gastroenterol, 2011, 45: S102-S105.
[17]
李铁男,王兵,刘影, 等. 菝葜提取物对肠易激综合征大鼠血浆SP、CGRP含量的影响[J]. 中医药学报, 2011, 39(4): 26-28.
[18]
Mönnikes H,van der Voort IR,Wollenberg B, et al.Gastric perception thresholds are low and sensory neuropeptide levels high in helico bacter pylori-positivefunctional dyspepsia[J]. Digestion, 2005, 71(2): 111-123.
[19]
Huang W,Jiang SM,Jia L, et al.Effect of amitriptyline on gastroin testinal function and brain-gut peptides：a double-blind trial[J]. World J Gastroenterol, 2013, 19(26): 4212-4220.
[1] 陈琅, 陈巧彬, 邹漳钰, 林立芳, 沈晓丽, 陈新, 季晓林. 戊四氮致癫痫大鼠不同脑区神经肽Y和亮氨酸–脑啡肽的表达及其意义[J]. 中华妇幼临床医学杂志(电子版), 2009, 05(01): 13-17.
[2] 张苗苗, 余小平, 付倩倩, 周军利. 外源性应用P物质促进糖尿病慢性创面愈合的研究进展[J]. 中华损伤与修复杂志(电子版), 2022, 17(02): 159-162.
[3] 陈孟竺, 韦小浪, 陈文霞. 神经肽P物质对人牙髓干细胞生物学行为的影响[J]. 中华口腔医学研究杂志(电子版), 2022, 16(06): 343-351.
[4] 王占彬, 达慧娟, 郝敏. 循环Tfh、肺神经源性P物质与哮喘病情程度的关系[J]. 中华肺部疾病杂志(电子版), 2021, 14(04): 447-449.
[5] 刘辉, 刘吉祥, 詹绍萍, 李文玲, 武江, 刘永军, 张鹏, 申仑, 李建华. 神经肽Y在人脑局灶性皮层发育不良不同Palmini病理亚型间的表达差异[J]. 中华神经创伤外科电子杂志, 2021, 07(05): 293-296.
[6] 李亚斌, 李刚, 王希瑞, 尚金星, 赵志煌. 依达拉奉辅助亚低温对重型颅脑创伤的血清细胞因子及凝血功能的影响[J]. 中华神经创伤外科电子杂志, 2020, 06(03): 166-171.
[7] 程亮, 朱良宇, 何涛. 重型创伤性脑损伤合并骨折患者血清CGRP的水平及与预后的关系[J]. 中华老年骨科与康复电子杂志, 2020, 06(06): 327-333.
[8] 中华医学会行为医学分会消化病学组. 癔球症多学科诊治中国专家共识[J]. 中华诊断学电子杂志, 2020, 08(04): 217-222.
[9] 何梓健, 贾林, 邓祺, 赵寒冰, 孟默, 郭婉薇. 癔球症患者临床精神心理学特征及少商穴经皮电刺激治疗的疗效评价[J]. 中华诊断学电子杂志, 2020, 08(02): 130-134.
[10] 陈冬云, 贾林. 癔球症患者食管上括约肌压力分型及其严重程度的影响因素[J]. 中华诊断学电子杂志, 2016, 04(03): 153-156.
[11] 梁慧敏, 梁军辉, 高洋. 功能性消化不良患者血浆神经肽Y和P物质水平与焦虑抑郁情绪的相关性[J]. 中华诊断学电子杂志, 2016, 04(03): 145-148.
[12] 杜秀云, 赛米·赛麦提, 赵新胜, 李赞林, 李义亮. P物质和降钙素基因相关肽及炎症因子在非糜烂性食管炎发生中的作用研究[J]. 中华胃食管反流病电子杂志, 2020, 07(03): 158-163.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号