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吞咽间隔对横纹食管蠕动的影响:与平滑肌食管的对比研究。

Effect of inter-swallow interval on striated esophagus peristalsis; a comparative study with smooth muscle esophagus.

机构信息

Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

出版信息

Neurogastroenterol Motil. 2023 Aug;35(8):e14608. doi: 10.1111/nmo.14608. Epub 2023 May 8.


DOI:10.1111/nmo.14608
PMID:37154414
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10789016/
Abstract

BACKGROUND: Effect of inter-swallow interval on the contractility of smooth muscle esophagus is well-documented. However, the effects on peristalsis of the striated esophagus have not been systematically studied. A better understanding of striated esophagus motor function in health and disease may enhance the interpretation of manometric studies and inform clinical care. The aim of this study was to assess the effect of inter-swallow interval on striated esophagus compared to findings with that of the smooth muscle esophagus. METHODS: We performed two sets of studies to (1) determine the effect of various inter-swallow interval in 20 healthy volunteers and (2) assess the effect of ultra-short swallow intervals facilitated by straw drinking in 28 volunteers. We analyzed variables using ANOVA with Tukey's pairwise comparison and paired t-test. KEY RESULTS: Unlike smooth muscle esophagus, the striated esophagus contractile integral did not change significantly for swallow intervals ranging from 30 to 5 s. On the contrary, striated esophagus demonstrated absent or reduced peristalsis in response to ultra-short (<2 s) intervals during straw-facilitated multiple rapid swallows. CONCLUSIONS AND INFERENCES: Striated esophagus peristalsis is subject to manometrically observed inhibition during swallows with ultra-short intervals. Inter-swallow intervals as short as 5 s that inhibit smooth muscle esophagus peristalsis do not inhibit striated muscle peristalsis. The mechanisms of these observations are unknown but may relate to central or myenteric nervous system influences or the effects of pharyngeal biomechanics.

摘要

背景:吞咽间期对平滑肌食管收缩力的影响已有充分的文献记载。然而,其对横纹肌食管蠕动的影响尚未得到系统研究。更好地了解健康和疾病状态下横纹肌食管的运动功能,可能会增强对测压研究的解读,并为临床护理提供信息。本研究旨在评估与平滑肌食管相比,吞咽间期对横纹肌食管的影响。

方法:我们进行了两组研究,(1)确定 20 名健康志愿者在不同吞咽间期下的影响,(2)评估 28 名志愿者通过吸管饮水促进超短吞咽间期的影响。我们使用方差分析(ANOVA)和 Tukey 配对比较以及配对 t 检验来分析变量。

主要结果:与平滑肌食管不同,吞咽间期在 30 至 5 秒范围内时,横纹肌食管的收缩积分没有明显变化。相反,在吸管促进多次快速吞咽时,超短(<2 秒)间期会导致横纹肌食管蠕动消失或减弱。

结论和推论:在超短吞咽间期时,横纹肌食管蠕动受到测压观察到的抑制。抑制平滑肌食管蠕动的间隔短至 5 秒并不会抑制横纹肌蠕动。这些观察结果的机制尚不清楚,但可能与中枢或肌间神经的影响或咽腔生物力学的影响有关。

相似文献

[1]
Effect of inter-swallow interval on striated esophagus peristalsis; a comparative study with smooth muscle esophagus.

Neurogastroenterol Motil. 2023-8

[2]
Responses of the human esophagus to paired swallows.

Gastroenterology. 1987-3

[3]
Multiple rapid swallow responses during esophageal high-resolution manometry reflect esophageal body peristaltic reserve.

Am J Gastroenterol. 2013-9-10

[4]
Coordination of peristalsis in pharynx and esophagus.

Dysphagia. 1993

[5]
Effect of time interval between swallows on esophageal peristalsis.

Am J Physiol. 1980-6

[6]
Physiology of esophageal motor function.

Gastroenterol Clin North Am. 1989-6

[7]
Effect of interval between swallows on oesophageal pressures and bolus movement in normal subjects - Studies with combined multichannel intraluminal impedance and oesophageal manometry.

Neurogastroenterol Motil. 2004-2

[8]
Absence of a deglutitive inhibition equivalent with secondary peristalsis.

Am J Physiol Gastrointest Liver Physiol. 2005-4

[9]
Relevance of ineffective esophageal motility to striated esophageal muscle contraction: Studies with high-resolution manometry.

Kaohsiung J Med Sci. 2024-10

[10]
Characterization and mechanism of the esophago-esophageal contractile reflex of the striated muscle esophagus.

Am J Physiol Gastrointest Liver Physiol. 2019-7-3

本文引用的文献

[1]
Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0.

Neurogastroenterol Motil. 2021-1

[2]
Multiple rapid swallows and rapid drink challenge in patients with esophagogastric junction outflow obstruction on high-resolution manometry.

Neurogastroenterol Motil. 2021-3

[3]
High Resolution Manometry With Multiple Rapid Swallows Confirms the Diagnosis of Type-III Achalasia in an Adolescent.

J Pediatr Gastroenterol Nutr. 2018-5

[4]
Optimal number of multiple rapid swallows needed during high-resolution esophageal manometry for accurate prediction of contraction reserve.

Neurogastroenterol Motil. 2017-11-21

[5]
Loss of Peristaltic Reserve, Determined by Multiple Rapid Swallows, Is the Most Frequent Esophageal Motility Abnormality in Patients With Systemic Sclerosis.

Clin Gastroenterol Hepatol. 2016-10

[6]
Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility.

Medicine (Baltimore). 2015-10

[7]
Relationship between multiple water swallows and gastroesophageal reflux in patients with normal esophageal motility.

Dis Esophagus. 2015

[8]
Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology.

Neurogastroenterol Motil. 2014-5

[9]
Multiple rapid swallow responses during esophageal high-resolution manometry reflect esophageal body peristaltic reserve.

Am J Gastroenterol. 2013-9-10

[10]
Contractile properties of esophageal striated muscle: comparison with cardiac and skeletal muscles in rats.

J Biomed Biotechnol. 2010

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