Omari T, Ross A, Schar M, Campbell J, Lewis D A, Robinson I, Farahani M, Cock C, Mossel B
Flinders University, Bedford Park, South Australia, Australia.
Trisco Foods, Carole Park, Queensland, Australia.
Neurogastroenterol Motil. 2025 Apr;37(4):e14988. doi: 10.1111/nmo.14988. Epub 2024 Dec 31.
The shear rheology of ingested fluids influences their pharyngo-esophageal transit during deglutition. Thus, swallowed fluids elicit differing physiological responses due to their shear-thinning profile.
Two hydrocolloid fluids, xanthan gum (XG) and sodium carboxymethylcellulose gum (CMC), were compared in 10 healthy adults (mean age 39 years). Manometry swallowing assessments were performed using an 8-French catheter. Swallows were analyzed using the Swallow Gateway web application (www.swallowgateway.com). Grouped data were analyzed by a mixed statistical model. The coefficient of determination (r) assessed the relationship between measures and bolus viscosity (SI units, mPa.s) at shear rates of 1-1000 s.
Rheology confirmed that the thickened fluids had similar viscosities at 50 s shear rate (XG IDDSI Level-1, 2, and 3 respectively, 74.3, 161.2, and 399.6 mPa.s vs. CMC Level-1, 2, and 3 respectively 78.0, 176.5, and 429.2 mPa.s). However, at 300 s shear, CMC-thickened fluids exhibited approximately double the viscosity (XG Level-1, 2, and 3 respectively 19.5, 34.4, and 84.8 mPa.s vs. CMC Level-1, 2, and 3 respectively, 41.3, 80.8, and 160.2 mPa.s). In vivo swallows of CMC, when compared to XG, showed evidence of greater flow resistance, such as increased intrabolus pressure (p < 0.01) and UES Integrated Relaxation Pressure (UESIRP, p < 0.01) and shorter UES Relaxation Time (p < 0.05) and Bolus Presence Time (p < 0.001). The apparent fluid viscosity (mPa.s) correlated most significantly with increasing UESIRP (r 0.69 at 50 s and r 0.97 at 300 s, p < 0.05).
Fluids with divergent shear viscosities demonstrated differences in pharyngeal function. These physiological responses were linked to the shear viscosity and not the IDDSI level.
摄入液体的剪切流变学影响其在吞咽过程中的咽食管转运。因此，由于其剪切变稀特性，吞咽的液体引发不同的生理反应。
在10名健康成年人（平均年龄39岁）中比较两种水胶体液体，即黄原胶（XG）和羧甲基纤维素钠胶（CMC）。使用8法式导管进行测压吞咽评估。使用吞咽网关网络应用程序（www.swallowgateway.com）分析吞咽情况。分组数据通过混合统计模型进行分析。决定系数（r）评估了在1 - 1000 s剪切速率下测量值与团块粘度（SI单位，mPa·s）之间的关系。
流变学证实，增稠液体在50 s剪切速率下具有相似的粘度（XG分别为IDDSI 1级、2级和3级，粘度分别为74.3、161.2和399.6 mPa·s；CMC分别为1级、2级和3级，粘度分别为78.0、176.5和429.2 mPa·s）。然而，在300 s剪切时，CMC增稠液体的粘度约为XG增稠液体的两倍（XG分别为1级、2级和3级，粘度分别为19.5、34.4和84.8 mPa·s；CMC分别为1级、2级和3级，粘度分别为41.3、80.8和160.2 mPa·s）。与XG相比，CMC的体内吞咽显示出更大的流动阻力迹象，如团块内压力增加（p < 0.01）和UES综合松弛压力（UESIRP，p < 0.01），以及UES松弛时间缩短（p < 0.05）和团块存在时间缩短（p < 0.001）。表观液体粘度（mPa·s）与UESIRP增加最显著相关（50 s时r = 0.69，300 s时r = 0.97，p < 0.05）。
具有不同剪切粘度的液体在咽部功能上表现出差异。这些生理反应与剪切粘度有关，而非IDDSI水平。
