Ghosh Sudip K, Pandolfino John E, Zhang Qing, Jarosz Andrew, Kahrilas Peter J
Northwestern University, Feinberg School of Medicine, Div. of Gastroenterology, Dept. of Medicine, 676 N. St. Clair St., Suite 1400, Chicago, IL 60611, USA.
Am J Physiol Gastrointest Liver Physiol. 2006 Sep;291(3):G525-31. doi: 10.1152/ajpgi.00081.2006. Epub 2006 Apr 27.
This study aimed to use a novel high-resolution manometry (HRM) system to establish normative values for deglutitive upper esophageal sphincter (UES) relaxation. Seventy-five asymptomatic controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record from the hypopharynx to the stomach. Subjects performed ten 5-ml water swallows and one each of 1-, 10-, and 20-ml volume swallows. Pressure profiles across the UES were analyzed using customized computational algorithms that measured 1) the relaxation interval (RI), 2) the median intrabolus pressure (mIBP) during the RI, and 3) the deglutitive sphincter resistance (DSR) defined as mIBP/RI. The automated analysis succeeded in confirming bolus volume modulation of both the RI and the mIBP with the mean RI ranging from 0.32 to 0.50 s and mIBP ranging from 5.93 to 13.80 mmHg for 1- and 20-ml swallows, respectively. DSR was relatively independent of bolus volume. Peak pharyngeal contraction during the return to the resting state postswallow was almost 300 mmHg, again independent of bolus volume. We performed a detailed analysis of deglutitive UES relaxation with a novel HRM system and customized software. The enhanced spatial resolution of HRM allows for the accurate, automated assessment of UES relaxation and intrabolus pressure characteristics, in both cases confirming the volume-dependent effects and absolute values of these parameters previously demonstrated by detailed analysis of concurrent manometry/fluoroscopy data. Normative values were established to aid in future clinical and investigative studies.
本研究旨在使用一种新型高分辨率测压（HRM）系统来建立吞咽时食管上括约肌（UES）松弛的正常值。对75名无症状对照者进行了研究。将一个带有36个周向传感器、间距为1厘米的固态HRM组件放置在从下咽到胃的位置进行记录。受试者进行了十次5毫升水吞咽，以及各一次1毫升、10毫升和20毫升体积的吞咽。使用定制的计算算法分析UES的压力曲线，该算法测量：1）松弛间隔（RI）；2）RI期间的团注期平均压力（mIBP）；3）吞咽括约肌阻力（DSR），定义为mIBP/RI。自动分析成功证实了RI和mIBP的团注体积调节，对于1毫升和20毫升的吞咽，平均RI分别为0.32至0.50秒，mIBP分别为5.93至13.80毫米汞柱。DSR相对独立于团注体积。吞咽后恢复到静息状态时的咽部收缩峰值几乎为300毫米汞柱，同样独立于团注体积。我们使用新型HRM系统和定制软件对吞咽时UES松弛进行了详细分析。HRM增强的空间分辨率允许对UES松弛和团注期压力特征进行准确、自动的评估，在这两种情况下都证实了先前通过同步测压/荧光透视数据详细分析所证明的这些参数的体积依赖性效应和绝对值。建立了正常值以帮助未来的临床和研究性研究。
