Shim Young Kwang, Kim Nayoung, Park Yo Han, Lee Jong-Chan, Sung Jihee, Choi Yoon Jin, Yoon Hyuk, Shin Cheol Min, Park Young Soo, Lee Dong Ho
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea.
J Neurogastroenterol Motil. 2017 Apr 30;23(2):229-236. doi: 10.5056/jnm16104.
BACKGROUND/AIMS: Disturbances of esophageal motility have been reported to be more frequent the aged population. However, the physiology of disturbances in esophageal motility during aging is unclear. The aim of this study was to evaluate the effects of age on esophageal motility using high-resolution esophageal impedance manometry (HRIM).
Esophageal motor function of 268 subjects were measured using HRIM in 3 age groups, < 40 years (Group A, n = 32), 40-65 years (Group B, n = 185), and > 65 years (Group C, n = 62). Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures, integrated relaxation pressure, distal contractile integral, contractile front velocity, distal latency, and pressures and duration of contraction on 4 positions along the esophagus, and complete bolus transit were measured.
Basal UES pressure was lower in Group C ( < 0.001) but there was no significant difference in the LES pressure among groups. Contractile duration on position 3 (10 cm from proximal LES high pressure zone) was longer in Group C ( = 0.001), and the contractile amplitude on position 4 (5 cm from proximal LES high pressure zone) was lower in Group C ( = 0.005). Distal contractile integral was lower in Group C ( = 0.037). Contractile front velocity ( = 0.015) and the onset velocity ( = 0.040) was lower in Group C. There was no significant difference in impedance values.
The decrease of UES pressure, distal esophageal motility, and peristaltic velocity might be related with esophageal symptoms in the aged population.
背景/目的:据报道,食管动力障碍在老年人群中更为常见。然而,衰老过程中食管动力障碍的生理学机制尚不清楚。本研究的目的是使用高分辨率食管阻抗测压法(HRIM)评估年龄对食管动力的影响。
使用HRIM对268名受试者进行食管运动功能测量,分为3个年龄组:<40岁(A组,n = 32)、40 - 65岁(B组,n = 185)和>65岁(C组,n = 62)。测量食管下括约肌(LES)和食管上括约肌(UES)压力、综合松弛压、远端收缩积分、收缩前沿速度、远端潜伏期、食管4个位置的压力和收缩持续时间,以及完整食团通过情况。
C组的基础UES压力较低(<0.001),但各组间LES压力无显著差异。C组在第3位置(距LES高压区近端10 cm)的收缩持续时间较长(=0.001),在第4位置(距LES高压区近端5 cm)的收缩幅度较低(=0.005)。C组的远端收缩积分较低(=0.037)。C组的收缩前沿速度(=0.015)和起始速度(=0.040)较低。阻抗值无显著差异。
UES压力降低、食管远端动力和蠕动速度降低可能与老年人群的食管症状有关。