Rohof W O A, Bredenoord A J
Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
Curr Gastroenterol Rep. 2017 Aug;19(8):37. doi: 10.1007/s11894-017-0576-7.
High-resolution manometry (HRM) is increasingly performed worldwide, to study esophageal motility. The Chicago classification is subsequently applied to interpret the manometric findings and facilitate a diagnosis of esophageal motility disorders. This review will discuss new insights regarding the diagnosis and management using the Chicago classification.
Recent studies have demonstrated that high-resolution manometry is superior to conventional manometry, and has a higher sensitivity to diagnose achalasia. Furthermore, the subclassification of achalasia as used in the Chicago classification has prognostic value and can be used to direct treatment. Diagnosis of esophageal spasm has been improved by using the distal latency as diagnostic criterion. Recently, criteria for minor disorders of peristalsis have been sharpened, leading to a lower rate of patients with abnormal results, thereby increasing the relevance of a diagnosis. High-resolution manometry is now considered the gold standard for diagnosis of esophageal motility disorders. The Chicago classification provides a standardized approach for analysis and categorization of abnormalities that has led to a significant increase in our knowledge regarding the diagnosis and management of motility disorders. Further refinement of the classification will be required.
高分辨率测压法（HRM）在全球范围内越来越多地用于研究食管动力。随后应用芝加哥分类法来解释测压结果并有助于诊断食管动力障碍。本综述将讨论使用芝加哥分类法在诊断和管理方面的新见解。
最近的研究表明，高分辨率测压法优于传统测压法，对诊断贲门失弛缓症具有更高的敏感性。此外，芝加哥分类法中使用的贲门失弛缓症亚分类具有预后价值，可用于指导治疗。通过将远端潜伏期用作诊断标准，食管痉挛的诊断得到了改善。最近，蠕动轻微障碍的标准得到了细化，导致结果异常的患者比例降低，从而提高了诊断的相关性。高分辨率测压法现在被认为是诊断食管动力障碍的金标准。芝加哥分类法为异常情况的分析和分类提供了一种标准化方法，这使得我们在动力障碍的诊断和管理方面的知识有了显著增加。还需要对该分类法进行进一步完善。
