无效食管动力与横纹食管肌收缩的相关性:高分辨率测压研究。
Relevance of ineffective esophageal motility to striated esophageal muscle contraction: Studies with high-resolution manometry.
机构信息
Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
出版信息
Kaohsiung J Med Sci. 2024 Oct;40(10):942-946. doi: 10.1002/kjm2.12884. Epub 2024 Aug 1.
Striated esophageal muscle contraction (SEC) is important for pharyngeal swallowing and deglutition augmentation against aspiration. Its clinical relevance is unclear in patients with ineffective esophageal motility (IEM). In this study, we aimed to characterize and compare SEC in consecutive patients with and without IEM. All eligible patients were evaluated for SEC, primary and secondary peristalsis using high-resolution manometry (HRM) with one mid-esophageal injection port. Primary peristalsis was assessed with 10 5-mL liquid swallows and multiple rapid swallows (MRS), while secondary peristalsis was performed with rapid air injections of 20 mL. All peristatic parameters of HRM were measured, and SEC and its contractile integral (SECI) were evaluated. One hundred and forty patients (59.3% women, mean age 46.1 ± 13.1 years) were included. There was no difference in SECI between patients with and without IEM (p = 0.91). SECI was also similar between patients with and without secondary peristalsis for IEM (p = 0.63) or normal motility (p = 0.80). No difference in SECI was seen between patients with and without MRS for IEM (p = 0.55) or normal motility (p = 0.88). SECI was significantly higher in male patients than female patients in IEM patients (p = 0.01). SECI significantly correlated with age in patients with normal motility (r = -0.31, p = 0.01). Aging may have a negative impact on SEC in patients with normal motility, while gender difference in SECI occurs in IEM patients. Neither secondary peristalsis nor MRS influences SECI.
食管横纹肌收缩(SEC)对于咽吞咽和防止误吸的吞咽增强很重要。其在无效食管动力(IEM)患者中的临床相关性尚不清楚。在这项研究中,我们旨在描述和比较连续 IEM 患者和非 IEM 患者的 SEC。所有符合条件的患者均使用带有一个食管中段注射端口的高分辨率测压法(HRM)评估 SEC、原发性和继发性蠕动。原发性蠕动通过 10 次 5 毫升液体吞咽和多次快速吞咽(MRS)评估,而继发性蠕动通过快速注入 20 毫升空气进行。测量 HRM 的所有蠕动参数,并评估 SEC 和其收缩积分(SECI)。共纳入 140 例患者(59.3%为女性,平均年龄 46.1±13.1 岁)。IEM 患者中 SECI 在有 SEC 和无 SEC 患者之间无差异(p=0.91)。对于 IEM 或正常动力患者,有 SEC 和无 SEC 患者的 SECI 也相似(p=0.63 和 p=0.80)。对于 IEM 或正常动力患者,有 MRS 和无 MRS 的患者的 SECI 之间无差异(p=0.55 和 p=0.88)。IEM 患者中,男性患者的 SECI 明显高于女性患者(p=0.01)。在正常动力患者中,SECI 与年龄显著相关(r=-0.31,p=0.01)。年龄增长可能对正常动力患者的 SEC 产生负面影响,而 SECI 在 IEM 患者中存在性别差异。继发性蠕动和 MRS 均不影响 SECI。