Ghosh Sudip K, Kahrilas Peter J, Lodhia Nilesh, Pandolfino John E
Department of Medicine, Northwestern University, Feinberg School of Medicine, Division of Gastroenterology, Chicago, IL 60611, USA.
Am J Physiol Gastrointest Liver Physiol. 2007 Nov;293(5):G1023-8. doi: 10.1152/ajpgi.00384.2007. Epub 2007 Sep 13.
Successful esophageal emptying depends on the generation of a sustained intrabolus pressure (IBP) sufficient to overcome esophagogastric junction (EGJ) obstruction. Our aim was to develop a manometric analysis paradigm that describes the bolus driving pressure difference and the flow permissive time for esophageal bolus transit. Twenty normal subjects were studied with a 36-channel manometry assembly (1-cm spacing) during two 5- and one 10-ml barium swallows and concurrent fluoroscopy. Bolus domain pressure plots were generated by plotting bolus domain pressure (BDP) and EGJ relaxation pressure. BDP was defined as the pressure midway between the peristaltic ramp-up and the proximal margin of the EGJ. The flow permissive time was defined as the period where the BDP was > or = EGJ relaxation pressure. The mean BDP was 11.7 +/- 1.0 mmHg (SE), and the mean flow permissive time was 3.9 +/- 0.4 s for 5-ml swallows in normal controls. The mean BDP difference during flow was 4.0 +/- 1.0 mmHg. There was no significant difference in the fluoroscopic transit time and the flow permissive time calculated from the BDP plots (5 ml: fluoroscopy 3.4 +/- 0.2 s; BDP 3.9 +/- 0.4 s, P > 0.05). BDP plots provide a reliable measurement of IBP and its relationship with EGJ relaxation. The time available for flow can be readily delineated from this analysis, and the driving pressure responsible for flow can be accurately described and quantified. This may help predict abnormal bolus transit and the underlying mechanical properties of the EGJ.
成功的食管排空取决于产生足以克服食管胃交界处（EGJ）梗阻的持续团块内压力（IBP）。我们的目的是开发一种测压分析范式，用于描述团块驱动压力差和食管团块传输的允许流动时间。在20名正常受试者进行两次5毫升和一次10毫升钡剂吞咽及同步荧光透视检查期间，使用36通道测压组件（间距1厘米）进行研究。通过绘制团块区域压力（BDP）和EGJ松弛压力生成团块区域压力图。BDP定义为蠕动上升和EGJ近端边缘之间的中间压力。允许流动时间定义为BDP大于或等于EGJ松弛压力的时间段。正常对照组中，5毫升吞咽时的平均BDP为11.7±1.0 mmHg（标准误），平均允许流动时间为3.9±0.4秒。流动期间的平均BDP差值为4.0±1.0 mmHg。荧光透视传输时间与根据BDP图计算的允许流动时间之间无显著差异（5毫升：荧光透视3.4±0.2秒；BDP 3.9±0.4秒，P>0.05）。BDP图可提供IBP及其与EGJ松弛关系的可靠测量。通过该分析可轻松确定流动可用时间，并且可准确描述和量化负责流动的驱动压力。这可能有助于预测异常团块传输及EGJ的潜在力学特性。
