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贲门失弛缓症和胃食管反流病中食管下括约肌和食管体的顺应性测量

Compliance measurement of lower esophageal sphincter and esophageal body in achalasia and gastroesophageal reflux disease.

作者信息

Jenkinson A D, Scott S M, Yazaki E, Fusai G, Walker S M, Kadirkamanathan S S, Evans D F

机构信息

Gastrointestinal Physiology Unit, St. Bartholomew's and the Royal London School of Medicine and Dentistry, The Royal London Hospital, UK.

出版信息

Dig Dis Sci. 2001 Sep;46(9):1937-42. doi: 10.1023/a:1010639232137.

DOI:10.1023/a:1010639232137
PMID:11575446
Abstract

Little is known about the effect of achalasia and gastroesophageal reflux disease (GERD) on compliance of the esophageal body and the lower esophageal sphincter (LES). Twenty-two patients with achalasia, 14 with GERD, and 14 asymptomatic volunteers were assessed. Recording apparatus consisted of a specially developed PVC bag tied to a compliance catheter, a barostat, and a polygraph. Intrabag pressures were increased incrementally while the bag volume was recorded. In each subject, pressure-volume graphs were constructed for both the esophageal body and LES and the compliance calculated. In achalasia, compliance of the esophageal body was significantly higher (P < 0.01) than in controls, whereas LES compliance was similar. Patients with GERD had a highly compliant LES in comparison to both controls and to patients with achalasia (P < 0.01 and P < 0.001, respectively); however there was no difference in their esophageal body compliance. In conclusion, foregut motility disorders can cause changes in organ compliance that are detectable using a barostat and a suitably designed compliance bag. Further measurement of compliance may provide clues to the pathogenesis of these disorders.

摘要

关于贲门失弛缓症和胃食管反流病(GERD)对食管体部和食管下括约肌(LES)顺应性的影响,目前所知甚少。对22例贲门失弛缓症患者、14例GERD患者和14名无症状志愿者进行了评估。记录装置由一个绑在顺应性导管上的特制聚氯乙烯袋、一个恒压器和一个测谎仪组成。在记录袋体积的同时,逐步增加袋内压力。为每个受试者构建食管体部和LES的压力-体积图,并计算顺应性。在贲门失弛缓症患者中,食管体部的顺应性显著高于对照组(P < 0.01),而LES顺应性相似。与对照组和贲门失弛缓症患者相比,GERD患者的LES顺应性很高(分别为P < 0.01和P < 0.001);然而,他们食管体部的顺应性没有差异。总之,前肠动力障碍可导致器官顺应性的改变,使用恒压器和适当设计的顺应性袋可以检测到这些改变。进一步测量顺应性可能为这些疾病的发病机制提供线索。

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