Hospices Civils de Lyon, Edouard Herriot Hospital, Digestive Physiology, Lyon F-69437, France.
Dig Liver Dis. 2012 Dec;44(12):976-80. doi: 10.1016/j.dld.2012.07.019. Epub 2012 Aug 28.
Achalasia is divided into 3 subtypes using the Chicago classification for high-resolution manometry. Aim of this study was to apply this classification to a multicentric French cohort of achalasia and to compare clinical and manometric characteristics between the 3 subtypes.
Oesophageal symptoms were collected in a retrospective study of patients diagnosed with achalasia on high-resolution manometry. Manometry data were analyzed with oesophago-gastric junction resting and relaxation pressures, and upper oesophageal sphincter resting pressure. Achalasia was classified according to the Chicago classification.
From 2007 to August 2011, achalasia was diagnosed in 169 patients, 14% classified as type I, 70% as type II and 16% as type III. Type III patients were older than types I and II (62 years vs. 52, p = 0.03). Ninety five percent of patients complained of dysphagia, 16% of chest pain (no difference between the 3 subtypes); 50% of type I patients presented regurgitations compared to 33% of type II and 22% of type III (p = 0.10). Oesophago-gastric junction and upper oesophageal sphincter pressures did not differ between the 3 groups.
Type II was the more prevalent subtype of achalasia in this French multicentre cohort. The older age of patients with type III achalasia suggests a different pathophysiology.
高分辨率测压法将贲门失弛缓症分为 3 个亚型，采用芝加哥分类。本研究的目的是将该分类应用于法国多中心贲门失弛缓症队列，并比较 3 个亚型的临床和测压特征。
在一项回顾性研究中，收集了诊断为高分辨率测压法贲门失弛缓症患者的食管症状。通过食管胃交界处静息和松弛压力以及上食管括约肌静息压力分析测压数据。根据芝加哥分类对贲门失弛缓症进行分类。
2007 年至 2011 年 8 月，169 例患者被诊断为贲门失弛缓症，其中 14%为 I 型，70%为 II 型，16%为 III 型。III 型患者比 I 型和 II 型年龄更大（62 岁 vs. 52 岁，p = 0.03）。95%的患者主诉吞咽困难，16%的患者诉胸痛（3 个亚型之间无差异）；I 型患者中有 50%出现反流，而 II 型和 III 型患者分别有 33%和 22%出现反流（p = 0.10）。食管胃交界处和上食管括约肌压力在 3 组之间无差异。
在这个法国多中心队列中，II 型是贲门失弛缓症更为常见的亚型。III 型贲门失弛缓症患者年龄较大，提示其病理生理学不同。
