Department of Medicine (Gastroenterology), The Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, 350 Community Drive, Manhasset, NY, 11030, USA,
Dig Dis Sci. 2014 Aug;59(8):1870-7. doi: 10.1007/s10620-014-3091-9. Epub 2014 Mar 8.
Little is known about the role of muscularis mucosa at the gastroesophageal junction (GEJ).
To evaluate the movement of the mucosa/muscularis-mucosa/submucosa (MMS) at the GEJ in normal subjects and in patients with gastroesophageal reflux disease (GERD).
Gastroesophageal junctions of 20 non-GERD subjects and 10 patients with GERD were evaluated during 5 mL swallows using two methods: in high-resolution endoluminal ultrasound and manometry, the change in the GEJ luminal pressures and cross-sectional area of esophageal wall layers were measured; in abdominal ultrasound, the MMS movement at the GEJ was analyzed.
Endoluminal ultrasound: In the non-GERD subjects, the gastric MMS moved rostrally into the distal esophagus at 2.17 s after the bolus first reached the GEJ. In GERD patients, the gastric MMS did not move rostrally into the distal esophagus. The maximum change in cross-sectional area of gastroesophageal MMS in non-GERD subjects and in GERD patients was 289 % and 183%, respectively. Abdominal ultrasound: In non-GERD subjects, the gastric MMS starts to move rostrally significantly earlier and to a greater distance than muscularis propria (MP) after the initiation of the swallow (1.75 vs. 3.00 s) and (13.97 vs. 8.91 mm). In GERD patients, there is no significant difference in the movement of gastric MMS compared to MP (6.74 vs. 6.09 mm). The independent movement of the gastric MMS in GERD subjects was significantly less than in non-GERD subjects.
In non-GERD subjects, the gastric MMS moves rostrally into the distal esophagus during deglutitive inhibition and forms a barrier. This movement of the MMS is defective in patients with GERD.
胃食管交界处（GEJ）的黏膜肌层的作用知之甚少。
评估正常人和胃食管反流病（GERD）患者的 GEJ 黏膜/黏膜肌-黏膜下层（MMS）的运动。
使用两种方法评估 20 名非 GERD 受试者和 10 名 GERD 患者的胃食管交界处：在高分辨率腔内超声和测压中，测量 GEJ 腔内压力和食管壁各层横截面积的变化；在腹部超声中，分析 GEJ 的 MMS 运动。
腔内超声：在非 GERD 受试者中，胃 MMS 在食团首次到达 GEJ 后 2.17 秒向远端食管向头侧移动。在 GERD 患者中，胃 MMS 没有向头侧移动进入远端食管。非 GERD 受试者和 GERD 患者的胃食管 MMS 最大横截面积变化分别为 289%和 183%。腹部超声：在非 GERD 受试者中，胃 MMS 在吞咽开始后比固有肌层（MP）更早且更远地向头侧移动（1.75 对 3.00 秒）和（13.97 对 8.91 毫米）。在 GERD 患者中，胃 MMS 的运动与 MP 相比没有显著差异（6.74 对 6.09 毫米）。GERD 患者胃 MMS 的独立运动明显少于非 GERD 患者。
在非 GERD 受试者中，胃 MMS 在吞咽抑制时向远端食管向头侧移动并形成屏障。这种 MMS 的运动在 GERD 患者中存在缺陷。
