Solazzo Antonio, Monaco Luigi, Vecchio Lucia Del, Reginelli Alfonso, Iacobellis Francesca, Capasso Raffaella, Tamburrini Stefania, Berritto Daniela, Barillari Maria Rosaria, Monsurrò Maria Rosaria, Di Martino Natale, Grassi Roberto
Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138, Naples, Italy,
Dysphagia. 2014 Oct;29(5):539-44. doi: 10.1007/s00455-014-9542-9. Epub 2014 Aug 21.
The aim of this study was to find whether there are manometric pharyngeal changes that may have diagnostic and prognostic relevance in the amyotrophic lateral sclerosis (ALS) patient who does not show changes in contrast-medium oropharyngeal transit in a videofluoroscopic swallowing study. Ten ALS patients, with an ALS Severity Scale Score of at least 7, no need to change dietary habit, no aspiration and/or penetration, and no other changes in contrast-medium oropharyngeal transit, were collected from our institution's database of videofluoromanometric swallowing studies. They were included in the study together with a group of 11 healthy volunteers. For each subject, 12 manometric items-7 for the pharyngeal phase and 5 for UES functionality-were evaluated. Statistically significant differences between the ALS patients and the healthy volunteers were found for pharyngeal contraction time of the upper region (median = 1,120, range = 880-1,420 vs. median = 970, range = 800-1,140), pharyngeal contraction time of the intermediate region (median = 1140, range = 960-1,360 vs. median = 770, range = 280-1,180), pharyngeal contraction time of the lower region (median = 1,320, range = 920-1,760 vs. median = 800, range = 620-1,780), and residual pressure after the relaxation of the UES (median = 2.2, range = -20.2 to 27.8 vs. median = -5.7, range = -2.9 to 8.4). A videofluoromanometric swallowing study may show an increase in the pharyngeal contraction time and in residual pressure after relaxation of the UES in ALS patients without videofluoroscopic changes in contrast-medium oropharyngeal transit.
本研究的目的是确定在肌萎缩侧索硬化症（ALS）患者中，是否存在测压法显示的咽部变化，这些变化可能在电视荧光吞咽研究中对造影剂口咽通过无变化的ALS患者具有诊断和预后意义。从我们机构的电视荧光测压吞咽研究数据库中收集了10例ALS患者，其ALS严重程度量表评分至少为7分，无需改变饮食习惯，无误吸和/或渗透，且造影剂口咽通过无其他变化。他们与一组11名健康志愿者一起被纳入研究。对每个受试者评估了12项测压指标——咽部阶段7项，UES功能5项。发现ALS患者与健康志愿者在上咽部收缩时间（中位数=1120，范围=880 - 1420 vs.中位数=970，范围=800 - 1140）、中咽部收缩时间（中位数=1140，范围=960 - 1360 vs.中位数=770，范围=280 - 1180）、下咽部收缩时间（中位数=1320，范围=920 - 1760 vs.中位数=800，范围=620 - 1780）以及UES松弛后的残余压力（中位数=2.2，范围=-20.2至27.8 vs.中位数=-5.7，范围=-2.9至8.4）方面存在统计学显著差异。在造影剂口咽通过无电视荧光变化的ALS患者中，电视荧光测压吞咽研究可能显示咽部收缩时间增加以及UES松弛后的残余压力增加。
