Tanaka Yoshimasa, Ihara Eikichi, Nakamura Kazuhiko, Muta Kazumasa, Fukaura Keita, Mukai Koji, Bai Xiaopeng, Takayanagi Ryoichi
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
J Gastroenterol Hepatol. 2016 Jun;31(6):1133-40. doi: 10.1111/jgh.13262.
Esophageal motility disorders (EMDs) affect coordinated esophageal contractility. Recent developments in high-resolution manometry have improved diagnosis of EMDs; however, the etiology of EMDs remains to be determined. This study aimed to determine which clinical characteristics are associated with esophageal motility.
From May 2013 to July 2014, 97 patients (54 women, 43 men; age, 16-89 years) with suspected EMDs were assessed by high-resolution manometry in Kyushu University Hospital. Esophageal motility was evaluated by measuring the distal contractile integral (DCI), basal lower esophageal sphincter pressure, and integrated relaxation pressure (IRP). Data on age, gender, body mass index (BMI), Brinkman Index, and blood tests were retrospectively collected and analyzed.
Fifty patients were diagnosed as normal, nine with achalasia, twelve with esophagogastric junction outflow obstruction, four with distal esophageal spasm, one with jackhammer esophagus, six with absent peristalsis, ten with frequent failed peristalsis, and five with weak peristalsis. The median DCI was 1229.0 mmHg-s-cm, the median basal lower esophageal sphincter pressure was 25.3 mmHg, and the median IRP was 9.6 mmHg. Patients with major motility disorders were excluded from analysis. By multivariate regression analysis, BMI (P = 0.029) and total cholesterol (P = 0.023) were negatively associated with DCI, while BMI (P = 0.007) was negatively associated with IRP and glucose (P = 0.044) was positively associated with IRP.
Both BMI and total cholesterol could be highly predictive factors for esophageal body contractility, while BMI and glucose could be predictive factors for lower esophageal sphincter contractile function.
食管动力障碍(EMDs)会影响食管的协调性收缩。高分辨率测压技术的最新进展改善了对EMDs的诊断;然而,EMDs的病因仍有待确定。本研究旨在确定哪些临床特征与食管动力相关。
2013年5月至2014年7月,九州大学医院对97例疑似EMDs的患者(54例女性,43例男性;年龄16 - 89岁)进行了高分辨率测压评估。通过测量远端收缩积分(DCI)、基础下食管括约肌压力和综合松弛压力(IRP)来评估食管动力。回顾性收集并分析了年龄、性别、体重指数(BMI)、 Brinkman指数和血液检查的数据。
50例患者被诊断为正常,9例为贲门失弛缓症,12例为食管胃交界流出道梗阻,4例为远端食管痉挛,1例为强力性食管,6例为无蠕动,10例为频繁无效蠕动,5例为弱蠕动。DCI的中位数为1229.0mmHg-s-cm,基础下食管括约肌压力的中位数为25.3mmHg,IRP的中位数为9.6mmHg。主要动力障碍患者被排除在分析之外。通过多因素回归分析,BMI(P = 0.029)和总胆固醇(P = 0.023)与DCI呈负相关,而BMI(P = 0.007)与IRP呈负相关,葡萄糖(P = 0.044)与IRP呈正相关。
BMI和总胆固醇都可能是食管体部收缩性的高度预测因素,而BMI和葡萄糖可能是下食管括约肌收缩功能的预测因素。