Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China; Department of Gastroenterology, Shanxi Cancer Hospital, Taiyuan, Shanxi Province, China.
J Gastroenterol Hepatol. 2013 Oct;28(10):1611-5. doi: 10.1111/jgh.12285.
Current normative data of high-resolution manometry have been obtained from Western populations, and esophageal motility disorders have been categorized using Chicago classification. However, the utility of high-resolution impedance manometry (HRiM) in the Chinese population has not been evaluated. The study aimed to investigate the normal reference of esophageal motility in healthy volunteers (as defined by Chicago classification) using HRiM.
Healthy, fasted volunteers underwent HRiM in a supine position with 10 liquid swallows and 10 viscous swallows. Integrated relaxation pressure (IRP), distal contractile integral (DCI), contractile front velocity (CFV), and distal latency were calculated. The interquartile ranges and the 95th percentile range for each metric were obtained.
Forty-two healthy volunteers were enrolled with 411 total liquid swallows and 398 viscous swallows available for analysis. A 20.5 mmHg of IRP and a 3195 mmHg·s·cm of DCI as the 95th percentile for liquid swallows were established. Using the reference range defined by Chicago classification, 6.3% (26/411) weak peristalsis and 0.7% (3/411) failed peristalsis for liquid swallows were observed; 12 (28.6%, 12/42) and 2 (4.7%, 2/42) individuals were diagnosed as esophagogastric junction outflow obstruction and weak peristalsis for liquid swallows. Compared with liquid swallows, viscous swallows had a decreased IRP (P = 0.000) and CFV (P = 0.000), and an unchanged DCI (P = 0.211).
HRiM normative data of both liquid and viscous swallows from healthy Chinese volunteers were established. The IRP and CFV were significantly decreased in the viscous swallows compared with those of the liquid swallows.
高分辨率测压法的现有参考标准数据来自西方人群，食管运动障碍采用芝加哥分类进行分类。然而，高分辨率阻抗测压法（HRiM）在中国人群中的应用尚未得到评估。本研究旨在通过 HRiM 评估健康志愿者（根据芝加哥分类定义）的食管运动正常参考值。
健康、空腹志愿者采用仰卧位，进行 10 次液体吞咽和 10 次粘性吞咽的 HRiM。计算整合松弛压（IRP）、远端收缩积分（DCI）、收缩前缘速度（CFV）和远端潜伏期。获得每个指标的四分位间距和 95%百分位范围。
共纳入 42 名健康志愿者，液体吞咽分析共有 411 次，粘性吞咽分析共有 398 次。液体吞咽的 IRP 为 20.5mmHg，DCI 为 3195mmHg·s·cm，为 95%百分位范围。根据芝加哥分类定义的参考范围，液体吞咽观察到 6.3%（26/411）为弱蠕动和 0.7%（3/411）为蠕动失败；12 名（28.6%，12/42）和 2 名（4.7%，2/42）个体被诊断为液体吞咽时食管胃连接部流出梗阻和弱蠕动。与液体吞咽相比，粘性吞咽的 IRP（P=0.000）和 CFV（P=0.000）降低，而 DCI 不变（P=0.211）。
建立了来自中国健康志愿者的液体和粘性吞咽 HRiM 正常参考值。与液体吞咽相比，粘性吞咽的 IRP 和 CFV 明显降低。
