Division of Gastroenterology, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611-2951, USA.
Am J Gastroenterol. 2010 May;105(5):981-7. doi: 10.1038/ajg.2010.43. Epub 2010 Feb 23.
The concept of high-resolution manometry (HRM) is to use sufficient pressure sensors such that intraluminal pressure can be monitored as a continuum along luminal length much as time is viewed as a continuum in conventional manometry. When HRM is coupled with pressure topography plots, pressure amplitude is transformed into spectral colors with isobaric conditions indicated by same-colored regions on the display. Together, these technologies are called high-resolution esophageal pressure topography (HREPT). HREPT has several advantages compared with conventional manometry, the technology that it was designed to replace. (i) The contractility of the entire esophagus can be viewed simultaneously in a uniform format, (ii) standardized objective metrics can be systematically applied for interpretation, and (iii) topographic patterns of contractility are more easily recognized and have greater reproducibility than with conventional manometry. Compared with conventional manometry, HREPT has improved sensitivity for detecting achalasia, largely due to the objectivity and accuracy with which it identifies impaired esophagogastric junction (EGJ) relaxation. In addition, it has led to the subcategorization of achalasia into three clinically relevant subtypes based on the contractile function of the esophageal body: classic achalasia, achalasia with esophageal compression, and spastic achalasia. Headway has also been made in understanding hypercontractile conditions, including diffuse esophageal spasm and a newly described entity, spastic nutcracker. Ultimately, clinical experience will be the judge, but it seems likely that HREPT data, along with its well-defined functional implications, will improve the clinical management of esophageal motility disorders.
高分辨率测压（HRM）的概念是使用足够多的压力传感器，以便能够沿管腔长度连续监测腔内压力，就像在常规测压中连续观察时间一样。当 HRM 与压力地形图结合使用时，压力幅度会转换为具有等压条件的光谱颜色，显示区域上相同颜色的区域表示等压条件。这些技术统称为高分辨率食管压力地形图（HREPT）。与旨在取代的常规测压技术相比，HREPT 具有几个优势。（i）整个食管的收缩性可以以统一的格式同时观察，（ii）可以系统地应用标准化的客观指标进行解释，以及（iii）与常规测压相比，收缩性的地形模式更容易识别且具有更高的可重复性。与常规测压相比，HREPT 提高了检测贲门失弛缓症的灵敏度，这主要是由于它客观准确地识别食管胃结合部（EGJ）松弛受损。此外，它还根据食管体的收缩功能将贲门失弛缓症分为三种具有临床相关性的亚型：经典贲门失弛缓症、食管压迫型贲门失弛缓症和痉挛性贲门失弛缓症。在理解高收缩性疾病方面也取得了进展，包括弥漫性食管痉挛和一种新描述的实体，痉挛性胡桃夹食管。最终，临床经验将是评判标准，但似乎 HREPT 数据及其明确的功能意义将改善食管动力障碍的临床管理。
