The role of mixed acid reflux and esophageal motility disorder in the occurrence of non-cardiac chest pain

doi:10.3877/cma.j.issn.2095-8765.2019.03.002

Abstract

Abstract:

Objective

Gastroesophageal reflux disease (GERD) is the most common cause of non-cardiogenic chest pain (NCCP). This study aimed to investigate the role of acid reflux patteren and esophageal motility in patients with NCCP.

Methods

According to inclusion and exclusion criteria, 40 patients with NCCP and 50 patients with typical GERD symptoms who diagnosed from September 2018 to June 2019 in Xinjiang Uygur Autonomous Region People’s Hospital were enrolled. Patients in both groups were asked to complete 24 h esophageal pH monitoring and high resolution esophageal manometry.

Results

The mean value of distal esophageal contraction (DCI) in NCCP group was significantly lower than that in GERD group (P＜0.05), suggesting impaired esophageal motor function. In NCCP group, mixed acid reflux that related to chest pain were significantly higher than those in GERD group (P＜0.05). In NCCP group, the clearance time of reflux associated with NCCP at 5, 9 and 15 cm of esophagus was longer than that in GERD group (28.3±4.21) s vs (22.6±3.28) s; (13.7±1.32) s vs (18.3±1.47) s; (9.58±1.02) s vs(14.3±1.06) s (P＜0.05).

Conclusion

The impairment of esophageal motor function, the nature of acid reflux and delayed clearance of reflux are may closely related to symptomatic seizures in NCCP patients.

Key words: gastroesophageal reflux disease, non-cardiac chest pain, acid reflux, high resolution esophageal manometry

Abulaikemu·Mahamuti, Maimaiti·Yisireyili, Xinsheng Zhao, Nueraili· Aini·Aili, Jing Yan, Yiliang Li, Lei Zhang, Kelimu·Abudureyimu. The role of mixed acid reflux and esophageal motility disorder in the occurrence of non-cardiac chest pain[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2019, 06(03): 121-125.

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References 15

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组别	NCCP组（n=40）	GERD组（n=50）	统计量χ² /t	P值
年龄（±s）	41.43±10.23	42.62±11.24	2.415	0.152
男性n（%）	24（60%）	32（64.0%）	2.754	0.261
BMI（kg/m²）（±s）	21.87±1.32	22.92±1.73	1.935	0.322
饮酒/咖啡	5（12.5%）/10（25.0%）	6（12.0%）/11（22.0%）	1.442	0.108
吸烟	6（15.0%）	7（14.0%）	2.104	0.114

组别	NCCP组（n=40）	GERD组（n=50）	统计量χ² /t	P值
年龄（±s）	41.43±10.23	42.62±11.24	2.415	0.152
男性n（%）	24（60%）	32（64.0%）	2.754	0.261
BMI（kg/m²）（±s）	21.87±1.32	22.92±1.73	1.935	0.322
饮酒/咖啡	5（12.5%）/10（25.0%）	6（12.0%）/11（22.0%）	1.442	0.108
吸烟	6（15.0%）	7（14.0%）	2.104	0.114

指标	NCCP组（n=40）	GERD组（n=50）	统计量t	P值
LES长度（cm）	3.02±0.52	3.16±0.37	1.716	0.503
LES静息压（mmHg）	20.32±5.16	23.15±4.43	2.247	0.714
CFV（cm/s）	4.28±0.45	4.74±0.28	1.107	0.328
IBP (平均最大值)（mmHg）	9.32±1.01	9.13±1.08	1.244	0.615
DCI平均值	915.46±265.45	1240.25±286.32^a	10.24	0.034

指标	NCCP组（n=40）	GERD组（n=50）	统计量t	P值
LES长度（cm）	3.02±0.52	3.16±0.37	1.716	0.503
LES静息压（mmHg）	20.32±5.16	23.15±4.43	2.247	0.714
CFV（cm/s）	4.28±0.45	4.74±0.28	1.107	0.328
IBP (平均最大值)（mmHg）	9.32±1.01	9.13±1.08	1.244	0.615
DCI平均值	915.46±265.45	1240.25±286.32^a	10.24	0.034

指标	NCCP组（n=40）	GERD组（n=50）	统计量t	P值
所有反流总次数/次	53.08±5.23	57.15±4.26	2.106	0.308
胃酸反流（%）	46.23±5.35	50.11±5.14	1.893	0.217
混合性反流（%）	64.24±6.24	42.17±4.78^a	6.247	0.043
食管近端反流（%）	45.13±5.67	50.86±4.50	1.268	0.216

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