Jørgensen F, Hesse B, Grønbaek P, Fogh J, Haunsø S
Dept. of Clinical Physiology, County Hospital of Hillerød, Denmark.
Scand J Gastroenterol. 1989 Dec;24(10):1186-92. doi: 10.3109/00365528909090785.
In 10 patients with enlarged atrium and in 29 patients with goiters and neck discomfort dynamic oesophageal scintigraphy was performed. The passage of water and capsules, containing 99mTc-pertechnetate, was studied with the patients in the supine and in the sitting positions. As a reference group we examined 35 healthy, age-matched volunteers. Mean transit time (MTT) was calculated, residual activity was expressed as a percentage of maximum activity, and the number of spikes in the curves was defined by visual analysis. Both in patients with enlarged left atrium and in those with large goiters the studies showed significantly prolonged MTT, increased residual activity, and a higher frequency of spikes, compared with healthy volunteers and with patients with small goiters. There was no relationship between symptoms and abnormal scintigraphic results. The passage of capsules was impaired only in cardiac patients. It is concluded that abnormal oesophageal function is often present in patients with enlarged left atrium and in patients with large, but not with small, goiters. Inhibition of oesophageal transit appears to be dependent on mechanical compression, but the nature of oesophageal impairment may vary with the level of compression. The frequent complaints of neck sensations in patients with goiters are probably not of oesophageal origin.
对10例心房增大患者和29例患有甲状腺肿且颈部不适的患者进行了动态食管闪烁扫描。让患者在仰卧位和坐位时研究含99m锝高锝酸盐的水和胶囊的通过情况。作为参照组，我们检查了35名年龄匹配的健康志愿者。计算平均通过时间（MTT），残余活性以最大活性的百分比表示，曲线中的尖峰数量通过视觉分析确定。与健康志愿者和小甲状腺肿患者相比，左心房增大患者和大甲状腺肿患者的研究均显示MTT显著延长、残余活性增加且尖峰频率更高。症状与闪烁扫描异常结果之间无关联。仅心脏病患者的胶囊通过受到损害。得出的结论是，左心房增大患者以及患有大而非小甲状腺肿的患者常存在食管功能异常。食管转运的抑制似乎取决于机械压迫，但食管损害的性质可能随压迫程度而异。甲状腺肿患者频繁出现的颈部感觉不适可能并非源于食管。
