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目的研究反流性食管炎与非糜烂性胃食管反流病(NERD)超微结构的特点。方法随机选取反流性疾病诊断问卷调查评分(Sc)在12分以上的13例患者,经胃镜检查7例诊断反流性食管炎(A 组),6例诊断 NERD(B 组),两组患者均取食管病理组织行透射电镜检查,其中7例患者行食管测压和24 h 食管 pH 监测检查。结果反流性疾病诊断问卷提示 A、B 两组患者症状评分差别无统计学意义;24 h 食管 pH 监测 A 组患者较 B 组患者存在较多的病理性酸反流;而 A、B 两组患者食管鳞状上皮细胞间隙增宽程度接近。结论胃食管反流患者均存在不同程度细胞间隙增宽,细胞间隙增宽可能导致 NERD 患者对生理性酸反流的高敏感性。
Objective To study the ultrastructural features of reflux esophagitis and non-erosive gastroesophageal reflux disease (NERD). Methods Thirteen patients with reflux score above 12 were randomly selected, 7 patients underwent gastroscopy to diagnose reflux esophagitis (group A), 6 patients to diagnose NERD (group B), two groups Patients underwent esophageal histopathology by transmission electron microscopy. Seven patients underwent esophageal manometry and 24-h esophageal pH monitoring. Results The diagnosis of reflux disease suggested that there was no significant difference in symptom scores between groups A and B; there was more pathological acid reflux in group A than in group B at 24 h; Patients with esophageal squamous cell gap widened the degree of close. Conclusion Gastroesophageal reflux patients have different degrees of cell gap widening and widening of cell gap, which may lead to high sensitivity to physiological acid reflux in patients with NERD.