Nguyen N Q, Rigda R, Tippett M, Conchillo J, Smout A J P M, Holloway R H
Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, SA, Australia.
Neurogastroenterol Motil. 2005 Jun;17(3):458-65. doi: 10.1111/j.1365-2982.2005.00646.x.
Multichannel intraluminal impedance (MII) is being used increasingly to assess oesophageal bolus clearance. However, there is no good standardization of the impedance parameters that define 'effective bolus clearance'. The aim of this study was to define these important impedance parameters and to determine their normal values. Concurrent perfusion manometry and MII were performed in 42 healthy volunteers. Ten, 5-mL liquid (saline) boluses and then, 10x5-mL low impedance viscous boluses were tested in each subject in the right-lateral position. Normal values for bolus presence time (BPT) at each site and total bolus transit time (TBTT) were determined from either 'normal' peristaltic responses (amplitude>or=30 mmHg in distal oesophagus) or 'super-normal' peristaltic responses (amplitudes>or=50 mmHg at all sites). The relationship between BPT and TBTT within a response and per-individual performance was determined. A total of 840 swallows of liquids and viscous responses were analysed. BPT and TBTT of viscous swallows were longer than those for liquids. Non-peristaltic responses were significantly more likely not to clear a viscous than a liquid bolus. Within a response, the number of sites with prolonged BPT strongly predicted the incidence of prolonged TBTT. Using impedance criteria, normal oesophageal bolus clearance is defined when an individual completely clears at least 70% of liquid responses and at least 60% of viscous responses. This study provides normal values for impedance measurement of bolus clearance when combined with perfusion manometry. These values will allow standardization of impedance application in oesophageal function testing, in both research and clinical setting.
多通道腔内阻抗（MII）越来越多地用于评估食管团块清除情况。然而，对于定义“有效团块清除”的阻抗参数，目前尚无良好的标准化。本研究的目的是确定这些重要的阻抗参数并确定其正常值。对42名健康志愿者同时进行灌注测压和MII检查。在每个受试者的右侧卧位测试10次5毫升液体（盐水）团块，然后测试10次5毫升低阻抗粘性团块。根据“正常”蠕动反应（食管远端振幅≥30 mmHg）或“超常”蠕动反应（所有部位振幅≥50 mmHg）确定每个部位的团块存在时间（BPT）和总团块通过时间（TBTT）的正常值。确定了反应内BPT与TBTT之间的关系以及个体表现。共分析了840次液体和粘性反应的吞咽情况。粘性吞咽的BPT和TBTT比液体吞咽的更长。非蠕动反应比液体团块更不容易清除粘性团块。在一次反应中，BPT延长的部位数量强烈预测了TBTT延长的发生率。使用阻抗标准，当个体至少完全清除70%的液体反应和至少60%的粘性反应时，定义为正常食管团块清除。本研究提供了与灌注测压相结合时团块清除阻抗测量的正常值。这些值将使阻抗在食管功能测试中的应用在研究和临床环境中实现标准化。
