Kurosugi Akane, Matsumura Tomoaki, Sonoda Michiko, Kaneko Tatsuya, Takahashi Satsuki, Okimoto Kenichiro, Akizue Naoki, Ohyama Yuhei, Mamiya Yukiyo, Nakazawa Hayato, Horio Ryosuke, Goto Chihiro, Ohta Yuki, Taida Takashi, Kikuchi Atsuko, Fujie Mai, Murakami Kentaro, Uesato Masaya, Ozawa Yoshihito, Kato Jun, Matsubara Hisahiro, Kato Naoya
Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan.
Clinical Research Center, Chiba University, Chiba, Japan.
Esophagus. 2024 Oct;21(4):546-551. doi: 10.1007/s10388-024-01069-5. Epub 2024 Jun 6.
Recently, the incidence of achalasia has been increasing, but its cause remains unknown. This study aimed to examine the initial symptoms and the course of symptoms and to find new insights into the cause and course of the disease.
Altogether, 136 patients diagnosed with achalasia by high-resolution manometry (HRM) were enrolled. Questionnaires and chart reviews were conducted to investigate the initial symptoms, time from onset to diagnosis, and comorbidities, as well as the relationship between HRM results, time to diagnosis, and symptom severity.
In total, 67 of 136 patients responded to the questionnaire. The median ages of onset and diagnosis were 42 and 58 years, respectively. The median time from onset to diagnosis was 78.6 months, with 25 cases (37.3%) taking > 10 years to be diagnosed. The symptom onset was gradual and sudden in 52 (77.6%) and 11 (16.4%) patients, respectively. Of the 11 patients with acute onset, three (27.3%) developed anhidrosis at the same time. There was no correlation between the time from onset to diagnosis and esophageal dilatation, resting LES pressure, or mean integrated relaxation pressure (IRP). No correlation was also found between the degree of symptoms and resting LES pressure or IRP.
Esophageal achalasia can have acute or insidious onsets. This finding may help to elucidate the cause of achalasia.
最近，贲门失弛缓症的发病率一直在上升，但其病因仍然不明。本研究旨在研究初始症状和症状过程，并对该疾病的病因和病程获得新的认识。
共纳入136例经高分辨率测压（HRM）诊断为贲门失弛缓症的患者。通过问卷调查和病历回顾来调查初始症状、从发病到诊断的时间、合并症，以及HRM结果、诊断时间和症状严重程度之间的关系。
136例患者中共有67例回复了问卷。发病和诊断的中位年龄分别为42岁和58岁。从发病到诊断的中位时间为78.6个月，25例（37.3%）患者诊断时间超过10年。症状起病逐渐出现的患者有52例（77.6%），突然起病的有11例（16.4%）。在11例急性起病的患者中，3例（27.3%）同时出现无汗症。从发病到诊断的时间与食管扩张、静息下食管下括约肌压力或平均综合松弛压（IRP）之间无相关性。症状程度与静息下食管下括约肌压力或IRP之间也未发现相关性。
食管贲门失弛缓症可急性起病或隐匿起病。这一发现可能有助于阐明贲门失弛缓症的病因。
