Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Sec. 3, Chung-Yang Rd., Hualien, Taiwan.
Dig Dis Sci. 2013 Apr;58(4):1042-8. doi: 10.1007/s10620-012-2463-2. Epub 2012 Oct 30.
Globus sensation is common, but its pathogenesis is not yet clear.
Our purpose was to investigate subjective perception of swallowing and esophageal motility by combined multichannel intraluminal impedance and manometry (MII-EM) for patients with globus sensation.
Combined MII-EM was performed for 25 globus patients and 15 healthy controls. Swallows were abnormal if hypocontractivity or simultaneous contractions occurred. Esophageal bolus transit was incomplete if bolus exit was not found at one or more of all measurement sites. Perception of each swallow was assessed by use of a standardized scoring system, and was enhanced if the score was >1.
Few globus patients reported enhanced perception during viscous or solid swallows. Incomplete bolus transit and enhanced perception occurred similarly between viscous and solid boluses. Agreement between enhanced perception and proximal bolus clearance was greater during solid swallows (κ = 0.45, 95 % CI: 0.32-0.58) than during viscous swallows (κ = 0.13, 95 % CI: 0-0.25) (P < 0.05). Similarly, agreement between enhanced perception and total bolus clearance was greater during solid swallows (κ = 0.46, 95 % CI: 0.34-0.58) than during viscous swallows (κ = 0.11, 95 % CI: 0-0.22) (P < 0.05).
Enhanced swallow perception is uncommon in patients with globus sensation, although there is a significant association between enhanced esophageal perception and solid bolus clearance. Application of a solid bolus may help better delineation of the interrelationship between the subjective perception of bolus passage and the objective measurement of bolus clearance.
球感是常见的，但它的发病机制尚不清楚。
我们的目的是通过多通道腔内阻抗和测压（MII-EM）联合研究球感患者的主观吞咽和食管动力感知。
对 25 例球感患者和 15 例健康对照者进行 MII-EM 检查。如果出现低收缩或同时收缩，则认为吞咽异常。如果在所有测量部位均未发现食团出口，则认为食团通过不完全。使用标准化评分系统评估每次吞咽的感知，如果评分>1，则认为感知增强。
很少有球感患者报告在粘性或固体吞咽时感知增强。粘性和固体食团的不完全通过和感知增强发生率相似。在固体吞咽时，感知增强与近端食团清除之间的一致性大于粘性吞咽（κ=0.45，95%CI：0.32-0.58）（P<0.05）。同样，在固体吞咽时，感知增强与总食团清除之间的一致性大于粘性吞咽（κ=0.46，95%CI：0.34-0.58）（P<0.05）。
球感患者吞咽感知增强并不常见，尽管食管感知增强与固体食团清除之间存在显著相关性。应用固体食团可能有助于更好地阐明食团通过的主观感知与食团清除的客观测量之间的相互关系。
