Nadaleto B F, Herbella F A M, Pinna B R, Patti M G
Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
Department of Ear, Nose and Throat, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
Dis Esophagus. 2017 Apr 1;30(4):1-5. doi: 10.1093/dote/dox001.
This study aims to evaluate the upper esophageal sphincter (UES) motility in patients with gastroesophageal reflux disease (GERD) as compared to healthy volunteers. We retrospectively studied the HRM tests of 44 patients (median age: 61 years, 54% females) under evaluation for GERD. The manometric UES parameters of these patients were compared to 40 healthy volunteers (median age: 27 years, 50% females). Almost half of the patients had a short and hypotonic UES. Patients with extraesophageal symptoms had a higher proportion of hypotonic UES as compared to patients with esophageal symptoms. Reflux pattern did not influence manometric parameters. Proximal reflux (any number of episodes) was present in 37(84%) patients (median number of proximal episodes = 6). Manometric parameters are similar in the presence or absence of proximal reflux. There is not a correlation between the UES length and UES basal pressure. In conclusion, our results show that: (1) the manometric profile of the UES in patients with GERD is characterized by a short and hypotonic UES in half of the patients; (2) this profile is more pronounced in patients with extraesophageal symptoms; and (3) neither the presence of proximal reflux nor reflux pattern bring a different manometric profile.
本研究旨在评估胃食管反流病（GERD）患者与健康志愿者相比，其食管上括约肌（UES）的运动功能。我们回顾性研究了44例接受GERD评估患者（中位年龄：61岁，54%为女性）的高分辨率测压（HRM）测试。将这些患者的UES测压参数与40名健康志愿者（中位年龄：27岁，50%为女性）进行比较。几乎一半的患者UES短且张力低。与有食管症状的患者相比，有食管外症状的患者UES张力低的比例更高。反流模式不影响测压参数。37例（84%）患者存在近端反流（任何次数的发作）（近端发作的中位次数=6）。有无近端反流时测压参数相似。UES长度与UES基础压力之间无相关性。总之，我们的结果表明：（1）GERD患者UES的测压特征是一半患者的UES短且张力低；（2）这种特征在有食管外症状的患者中更明显；（3）近端反流的存在和反流模式均不会带来不同的测压特征。
