Ilhan Muzaffer, Danalioglu Ahmet, Turgut Seda, Karaman Ozcan, Arabaci Elif, Tasan Ertugrul
Bezmialem University.
Endokrynol Pol. 2015;66(4):308-12. doi: 10.5603/EP.2015.0039.
Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients.
The study was performed in an institutional referral centre at a tertiary care hospital. Twenty-three acromegaly patients (mean age 43.2 ± 13.2 years) and 25 sex- and age-matched healthy control subjects (mean age 48.6 ± 7.9 years) were recruited to a case-control study. Oesophageal manometry was performed using MMS (Medical Measurement Systems, Netherlands) Solar GI - Air Charged Intelligent Gastrointestinal Conventional Manometry.
In manometric measurements the lower oesophageal sphincter pressure was 18 ± 7 mmHg in acromegaly patients and 15.6 ± 4.4 mm Hg in controls, and there was no significant difference (p = 0.17). The percentage of relaxation was 64.8% and 81.8%, respectively, and it was significantly lower in acromegaly patients than in controls (p < 0.001). Additionally, the duration of relaxation was found to be 4 ± 1.9 seconds and 5 ± 1.7 seconds in patients and controls, respectively (p = 0.049).
Our study has demonstrated a significant reduction in the percentage and duration of lower oesophageal sphincter relaxation in oesophagus motility even in acromegaly patients without any gastrointestinal symptoms. Further clinical and pathophysiological studies are required to clarify the underlying mechanisms of gastrointestinal motility disorders in acromegaly.
尽管已证实肢端肥大症患者的小肠和结肠转运时间延长,但肢端肥大症对食管动力的影响及相关病理机制仍未阐明。我们旨在通过测压测量来确定活动期肢端肥大症患者的食管动力是否受到影响。
本研究在一家三级护理医院的机构转诊中心进行。一项病例对照研究纳入了23例肢端肥大症患者(平均年龄43.2±13.2岁)和25例年龄及性别匹配的健康对照者(平均年龄48.6±7.9岁)。使用荷兰Medical Measurement Systems公司的MMS Solar GI - 空气充注智能胃肠传统测压法进行食管测压。
在测压测量中,肢端肥大症患者的食管下括约肌压力为18±7 mmHg,对照组为15.6±4.4 mmHg,差异无统计学意义(p = 0.17)。松弛百分比分别为64.8%和81.8%,肢端肥大症患者显著低于对照组(p < 0.001)。此外,患者和对照组的松弛持续时间分别为4±1.9秒和5±1.7秒(p = 0.049)。
我们的研究表明,即使在没有任何胃肠道症状的肢端肥大症患者中,食管动力中食管下括约肌的松弛百分比和持续时间也显著降低。需要进一步的临床和病理生理学研究来阐明肢端肥大症患者胃肠动力障碍的潜在机制。