Division of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Clin Gastroenterol. 2012 Jul;46(6):442-8. doi: 10.1097/MCG.0b013e31823d30c1.
High-resolution manometry has added significantly to our current understanding of esophageal motor function by providing improved detail and a data analysis paradigm that is more akin to an imaging format. Esophageal pressure topography provides a seamless dynamic representation of the pressure profile through the entire esophagus and thus, is able to eliminate movement artifact and also assess intrabolus pressure patterns as a surrogate for bolus transit mechanics. This has led to improved identification of anatomic landmarks and measurement of important physiological parameters (esophagogastric junction relaxation, distal latency, and contractile integrity). This research has bridged the gap into clinical practice by defining physiologically relevant phenotypes that may have prognostic significance and improve treatment decisions in achalasia, spasm, and hypercontractile disorders. However, more work is needed in determining the etiology of symptom generation in the context of normal or trivial motor dysfunction. This research will require new techniques to assess visceral hypersensitivity and alterations in central modulation of pain and discomfort.
高分辨率测压法通过提供更详细的信息和更类似于成像格式的数据分析方法，极大地增进了我们对食管运动功能的现有认识。食管压力地形图提供了整个食管压力曲线的无缝动态表示，因此能够消除运动伪影，并评估腔内压力模式作为食团转运力学的替代指标。这有助于提高解剖学标志的识别能力和重要生理参数（食管胃结合部松弛、远端潜伏期和收缩完整性）的测量。这项研究通过定义具有预后意义的生理相关表型，并改善贲门失弛缓症、痉挛和高收缩性障碍的治疗决策，将差距缩小到临床实践中。然而，在正常或轻微运动功能障碍的情况下，需要更多的工作来确定症状产生的病因。这项研究将需要新的技术来评估内脏敏感性和疼痛和不适的中枢调节变化。
