Study on the contraction pattern of esophageal body in 27 patients with non-cardiac chest pain / 中华消化杂志

ABSTRACT

Objective:To analyze the differences in the contraction pattern of esophageal body in patients with different types of non-cardiac chest pain (NCCP).Methods:From January 1, 2019 to December 31, 2020, 46 NCCP patients visited the First Affiliated Hospital of Zhejiang Chinese Medical University were selected. According to the Lyon consensus and Rome Ⅳ dignostic criteria, combined with the results of gastr oscopy and 24 h muitichannel intraluminal impedance combined with pH detection monitoring, 27 patients were finally included. The 27 patients were divided into functional chest pain group (12 cases) and gastroesophageal reflux disease (GERD) group (15 cases). The differences in contraction pattern of esophageal body between the two groups were analyzed according to the results of high-resolution esophageal manometry (the maximal wave amplitude of each contraction segment (S1, S2, S3), average contraction amplitude, contraction transmission time, segment lengths, distal contractile integral (DCI) and the DCI ratio of S2 to S3). Independent sample t test and chi-square test were used for statistical analysis. Results:The segment length and contraction transmission time of S3 in GERD group were shorter than those in functional chest pain group, the DCI of S3 in GERD group was lower than that in functional chest pain group, and the DCI ratio of S2 to S3 was higher than that of functional chest pain group ((5.69±0.55) cm vs. (6.61±0.99) cm, (3.45±0.49) s vs. (4.15±0.90) s, (798.88±354.70) mmHg·s·cm (1 mmHg=0.133 kPa) vs. (1 421.45±802.47) mmHg·s·cm, 0.99±0.44 vs. 0.67±0.17), and the differences were statistically significant ( t=2.682, 2.249, 2.308 and -2.616, all P<0.05). In GERD group, the transmitted segment length of S2 was longer than that of S3 ((7.02±1.40) cm vs. (5.69±0.55) cm), the contraction time of S2 of functional chest pain group was shorter than that of S3 ((3.29±0.80) s vs. (4.15±0.90) s), and the differences were statistically significant ( t=3.413 and -2.269, both P<0.05). Conclusion:High-amplitude contraction of S3 mainly occurs in patients with functional chest pain rather than GERD patients, suggesting that it may have a certain value in differential diagnosis of functional chest pain and GERD.