do Carmo G C, Jafari J, Sifrim D, de Oliveira R B
Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Neurogastroenterol Motil. 2015 Feb;27(2):285-92. doi: 10.1111/nmo.12501. Epub 2015 Jan 3.
Normal values of the esophageal motor function parameters for high-resolution manometry (HRM-EPT) adopted by the Chicago classification were established using the proprietary system of Given Imaging. It is conceivable that normal values of a system do not apply to data from others. Most studies using HRM were based on supine swallows, whereas deglutition occurs mostly in the upright position. We wished to establish normal values for HRM-EPT parameters obtained with the Sandhill's HRM-EPT system and compare the results in supine and sitting positions.
Sixty-nine healthy volunteers, 38 females, median age 27 years, were included in this study. All underwent supine HRM, and 34 of them underwent sitting HRM, with at least 10 single 5-mL swallows for analysis obtained in each position.
The normal range (5-95th percentiles) for the following parameters was calculated: distal contractile integral (DCI), 606-4998 mmHg·s·cm; contractile front velocity (CFV), 2.0-6.5 cm/s; distal latency (DL), 5.1-8.8 s; intrabolus pressure (IBP), 1.9-17.6 mmHg; upper esophageal sphincter (UES) pressure, 45.2-186.9 mmHg; esophagogastric junction (EGJ) length, 1.8-4 cm; EGJ resting pressure, 8.1-61.6 mmHg, and integrated relaxation pressure (IRP) 2.5-23.5 mmHg. Normal values of EGJ resting pressure, IRP, DCI, and IBP but not CFV, DL, and UES resting pressure were significantly lower in the sitting posture.
CONCLUSIONS & INFERENCES: Studies performed with Sandhill's HRM-EPT system should use its own specific normal data. Normal values should be established for different study.
芝加哥分类法采用的高分辨率测压法(HRM-EPT)食管运动功能参数的正常值是使用Given Imaging公司的专有系统确定的。可以想象,一个系统的正常值并不适用于其他系统的数据。大多数使用HRM的研究基于仰卧吞咽,而吞咽大多发生在直立位。我们希望确定使用Sandhill's HRM-EPT系统获得的HRM-EPT参数的正常值,并比较仰卧位和坐位的结果。
本研究纳入了69名健康志愿者,其中38名女性,年龄中位数为27岁。所有人均接受了仰卧位HRM检查,其中34人接受了坐位HRM检查,每个体位至少获取10次5毫升单次吞咽用于分析。
计算了以下参数的正常范围(第5至95百分位数):远端收缩积分(DCI),606 - 4998mmHg·s·cm;收缩波前速度(CFV),2.0 - 6.5cm/s;远端潜伏期(DL),5.1 - 8.8s;团注内压(IBP),1.9 - 17.6mmHg;食管上括约肌(UES)压力,45.2 - 186.9mmHg;食管胃交界处(EGJ)长度,1.8 - 4cm;EGJ静息压,8.1 - 61.6mmHg,以及综合松弛压(IRP)2.5 - 23.5mmHg。坐位时EGJ静息压、IRP、DCI和IBP的正常值显著低于仰卧位,但CFV、DL和UES静息压的正常值无显著差异。
使用Sandhill's HRM-EPT系统进行的研究应使用其自身特定的正常数据。不同的研究应建立各自相应的正常值。