Tutuian Radu, Vela Marcelo F, Balaji Nagammapudur S, Wise James L, Murray Joseph A, Peters Jeffrey H, Shay Steven S, Castell Donald O
Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Clin Gastroenterol Hepatol. 2003 May;1(3):174-82. doi: 10.1053/cgh.2003.50026.
BACKGROUND & AIMS: Combined multichannel intraluminal impedance and manometry (MII-EM) assesses esophageal function by simultaneous measurement of both pressure and bolus transit. Normative data for this method have not been published. The aim of this study was to establish normative data for combined MII-EM and to correlate liquid and viscous bolus transit by impedance with esophageal contractions by manometry.
Forty-three normal volunteers recruited from 4 centers (15 women, 28 men; age range, 21-72 years) underwent combined MII-EM with a catheter containing 4 impedance-measuring segments and 4 solid-state pressure transducers. Each center recruited and analyzed subjects independently, according to pre-established criteria. Each subject received 20 x 5 mL swallows, 10 liquid and 10 viscous material. Tracings were analyzed manually for bolus presence time, bolus head advance time, segmental transit times, total bolus transit time, contraction amplitude, duration, and onset velocity.
Ninety-seven and four-tenths percent of manometrically normal liquid and 96.1% of manometrically normal viscous swallows had complete bolus transit by impedance. Almost half (47.2%) of manometrically ineffective liquid and 34.7% of ineffective viscous swallows had complete bolus transit, whereas 91.7% of manometric simultaneous liquid swallows and 54.5% of simultaneous viscous swallows had complete bolus transit. More than 93% of normal individuals had at least 80% complete liquid or at least 70% complete viscous bolus transit.
This study establishes normative data for combined MII-EM. Combined MII-EM may be a more sensitive tool in assessing esophageal function compared to standard manometry because impedance can distinguish different bolus transit patterns. Studies in patients with manometrically defined esophageal motility abnormalities should help clarify the functional importance of manometric ineffective and simultaneous swallows.
联合多通道腔内阻抗与测压法（MII-EM）通过同时测量压力和食团通过情况来评估食管功能。该方法的规范数据尚未公布。本研究的目的是建立联合MII-EM的规范数据，并将通过阻抗测量的液体和粘性食团通过情况与通过测压法测量的食管收缩情况相关联。
从4个中心招募了43名正常志愿者（15名女性，28名男性；年龄范围21-72岁），使用包含4个阻抗测量段和4个固态压力传感器的导管进行联合MII-EM检查。每个中心根据预先制定的标准独立招募和分析受试者。每个受试者吞咽20次，每次5毫升，其中10次吞咽液体，10次吞咽粘性物质。对手动分析记录的食团存在时间、食团头部推进时间、节段性通过时间、食团总通过时间、收缩幅度、持续时间和起始速度进行分析。
在测压正常的吞咽中，97.4%的液体吞咽和96.1%的粘性吞咽通过阻抗测量显示食团完全通过。在测压无效的吞咽中，近一半（47.2%）的液体吞咽和34.7%的粘性吞咽食团完全通过，而在测压同步的液体吞咽中，91.7%和同步的粘性吞咽中54.5%的食团完全通过。超过93%的正常个体至少80%的液体食团或至少70%的粘性食团完全通过。
本研究建立了联合MII-EM的规范数据。与标准测压法相比，联合MII-EM在评估食管功能方面可能是一种更敏感的工具，因为阻抗可以区分不同的食团通过模式。对测压定义的食管动力异常患者的研究应有助于阐明测压无效和同步吞咽的功能重要性。
