Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Otolaryngol Head Neck Surg. 2011 Oct;145(4):618-22. doi: 10.1177/0194599811407280. Epub 2011 Apr 26.
This study tested the hypotheses that swallowing apnea duration (SAD) will increase given chemesthetic stimuli (ie, water < ethanol, acid, and carbonation), age (older > young), and genetic taste differences (supertasters > nontasters).
Prospective group design.
University medical center.
Eighty healthy adult women were identified as nontasters and supertasters, equally comprising 2 age groups: 18 to 35 years (n = 40) and 60+ years (n = 40). The KayPentax Swallowing Signals Lab was used to acquire SAD via nasal cannula during individually randomized swallows of 5 mL deionized water, 2.7% w/v citric acid, seltzer water, and 50:50 diluted ethanol/water. Data were analyzed using path analysis, with the mediator of chemesthetic perception, adjusted for repeated measures.
Significant main effects of chemesthetic stimuli (P = .002), age (P < .001), and genetic taste differences (P = .04) on SAD were found. Older women and supertasters had longer SADs than young women and nontasters. Post hoc analyses revealed ethanol and acid boluses elicited significantly longer SADs than water boluses did. There was no significant effect of chemesthetic perception (P > .05).
SAD in healthy women increased with changes in chemesthetic stimuli, older age, and in supertasters versus nontasters. It is unclear at this stage if increased SAD is a helpful mechanistic change (potentially protective against aspiration) or a maladaptive change (associated with aspiration). Future research should use these chemesthetic changes in bolus properties to assess if increased SAD decreases aspiration in patients with dysphagia while accounting for genetic taste differences.
本研究旨在验证以下假设:化学刺激(即水<乙醇、酸和碳酸化)、年龄(老年人>年轻人)和遗传味觉差异(超敏者>非超敏者)会导致吞咽暂停时间(SAD)增加。
前瞻性组设计。
大学医疗中心。
确定了 80 名健康成年女性为非超敏者和超敏者,他们分为 2 个年龄组:18 至 35 岁(n=40)和 60 岁以上(n=40)。使用 KayPentax 吞咽信号实验室通过鼻导管获取 SAD,在单独随机吞咽 5 毫升去离子水、2.7%w/v 柠檬酸、苏打水和 50:50 稀释的乙醇/水时进行。使用路径分析对数据进行分析,调整了化学感觉感知的中介作用,以进行重复测量。
发现化学刺激(P=0.002)、年龄(P<0.001)和遗传味觉差异(P=0.04)对 SAD 有显著的主效应。老年女性和超敏者的 SAD 比年轻女性和非超敏者长。事后分析显示,乙醇和酸弹丸比水弹丸引起的 SAD 明显更长。化学感觉感知没有显著影响(P>0.05)。
健康女性的 SAD 随着化学刺激、年龄增长和超敏者与非超敏者的变化而增加。在现阶段,尚不清楚增加的 SAD 是一种有益的机制变化(可能有助于防止吸入)还是一种适应不良的变化(与吸入有关)。未来的研究应使用这些化学刺激变化来评估吞咽困难患者的 SAD 是否会减少吸入,同时考虑遗传味觉差异。