Dalton C B, Castell D O, Hewson E G, Wu W C, Richter J E
Department of Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27103.
Dig Dis Sci. 1991 Aug;36(8):1025-8. doi: 10.1007/BF01297441.
Diffuse esophageal spasm (DES) has frequently been described as a motility disorder characterized by simultaneous, high-amplitude contractions. We reviewed the results of esophageal manometry testing on a total of 1480 patients referred to our lab over 36 months. Lower esophageal sphincter (LES) pressure was determined by a mean of four station pull-through. Esophageal body motility was assessed following 10 wet swallows. In our lab a diagnosis of DES is made when greater than 10% but less than 100% of contractions are simultaneous. Manometric findings of DES were rare, with an overall prevalence of 4% (56/1480). Of the 56 patients with a manometric diagnosis of DES, high-amplitude (mean greater than or equal to 180 mm Hg) peristaltic contractions were found in only two (4%). No simultaneous contractions with amplitude greater than or equal to 180 mm Hg were seen. Pressures of simultaneous contractions were consistently lower than peristaltic contractions. A hypertensive LES pressure (greater than or equal to 45 mm Hg) was present in 5/56 DES patients (9%). Poor LES relaxation was found in 7/56 DES patients (13%). We conclude that DES is a rare manometric finding, regardless of the reason for referral, and that the occurrence of high-amplitude contractions in DES is equally rare.
弥漫性食管痉挛（DES）常被描述为一种以同时出现高振幅收缩为特征的动力障碍性疾病。我们回顾了36个月内转诊至我们实验室的1480例患者的食管测压测试结果。通过平均四个位点的牵拉法测定食管下括约肌（LES）压力。在进行10次湿吞咽后评估食管体部动力。在我们实验室，当超过10%但少于100%的收缩同时出现时可诊断为DES。DES的测压结果很罕见，总体患病率为4%（56/1480）。在56例经测压诊断为DES的患者中，仅2例（4%）发现高振幅（平均大于或等于180 mmHg）蠕动性收缩。未见到振幅大于或等于180 mmHg的同时收缩。同时收缩的压力始终低于蠕动性收缩。56例DES患者中有5例（9%）存在LES压力升高（大于或等于45 mmHg）。56例DES患者中有7例（13%）发现LES松弛不良。我们得出结论，无论转诊原因如何，DES都是一种罕见的测压表现，并且DES中出现高振幅收缩同样罕见。
