Cordier L, Bohn B, Bonaz B, Gueddah N, Bost R, Fournet J
Département d'Hépato-Gastroentérologie, CHU, Grenoble.
Gastroenterol Clin Biol. 1999 Feb;23(2):200-6.
The aim of this study was to define the normal manometric pattern of esophageal motility in response to food ingestion and to evaluate the contribution of esophageal manometry in the management of patients complaining of functional dysphagia.
Twenty-one healthy volunteers and 25 consecutive patients complaining of functional dysphagia with normal conventional esophageal manometry were included in this prospective study. An event marker was used to study the relationship between dysphagia and motility events.
Twenty-two out of 25 patients (88%) reported dysphagia during esophageal manometry with food ingestion, while none complained of dysphagia during conventional esophageal manometry. Significantly, food ingestion induced in healthy volunteers and in patients: an increase in the amplitude and duration of esophageal body peristaltic contractions, and a decrease in their propagation speed; an increase in the basal pressure and a decrease in the relaxation percentage of the lower esophageal sphincter during deglutition. The percentage of solid swallows with one or several of the 7 abnormal motility patterns studied prospectively was significantly higher among patients (53.7%) than among healthy volunteers (4.3%) (P < 0.0001); it was also significantly higher among patients during swallows with dysphagia (70.1%) than without dysphagia (33.6%) (P < 0.0001).
Esophageal manometry with food ingestion is an effective means of defining abnormal motility patterns and their relationship with dysphagia during functional dysphagia.
本研究的目的是确定食管对食物摄入的正常测压模式,并评估食管测压在管理主诉功能性吞咽困难患者中的作用。
本前瞻性研究纳入了21名健康志愿者和25名连续的主诉功能性吞咽困难且传统食管测压正常的患者。使用事件标记物来研究吞咽困难与动力事件之间的关系。
25名患者中有22名(88%)在食管测压时摄入食物期间报告有吞咽困难,而在传统食管测压期间无人主诉吞咽困难。值得注意的是,食物摄入在健康志愿者和患者中均引起:食管体蠕动收缩的幅度和持续时间增加,其传播速度降低;吞咽时食管下括约肌的基础压力增加,松弛百分比降低。前瞻性研究的7种异常动力模式中出现一种或几种的固体吞咽百分比在患者中(53.7%)显著高于健康志愿者(4.3%)(P<0.0001);在有吞咽困难的患者吞咽期间(70.1%)也显著高于无吞咽困难的患者(33.6%)(P<0.0001)。
摄入食物时进行食管测压是确定功能性吞咽困难期间异常动力模式及其与吞咽困难关系的有效方法。