Langevin S, DeNuna S F, Castell D O
Division of Gastroenterology and Hepatology, Jefferson Medical College, Philadelphia, Pennsylvania.
Dig Dis Sci. 1993 Feb;38(2):225-32. doi: 10.1007/BF01307539.
With the development of a portable high-capacity data-recording device and fully automated computer analysis, it is now possible to monitor esophageal motility in an ambulatory outpatient setting and over a complete circadian cycle. However, limited data are available on the characteristics and pattern of esophageal motility in healthy subjects, particularly the effects of meals. We studied the effect of food types (liquid vs solid) and standardized vs nonstandardized diet on 17 healthy volunteers with a probe combining three miniature pressure transducers 5 cm apart. All subjects followed the same diet regimen: a standardized breakfast, strict liquid lunch, and no restriction for composition and quantity of dinner. The characteristics of contraction events (amplitude, duration, velocity, slope, area under curve) and their propagation types (peristaltic, simultaneous, segmental, retrograde) were analyzed and compared to supine and interprandial periods. The contraction characteristics and the propagation pattern were identical for the three types of meals. In comparison with the interprandial and supine periods, the three types of meals showed higher percent peristaltic contractions and smaller percent simultaneous contractions. The individual contraction characteristics were, however, not significantly different. Higher percentages of simultaneous, retrograde, and segmental contractions were found during the supine period than either the perprandial or interprandial periods. This study indicates that characteristics of esophageal contractions and propagation pattern are similar for meals of different composition and quantity. In comparison with interprandial and supine periods, the meals are always characterized predominantly by peristaltic contractions. Thus, standardization of meals during prolonged ambulatory pressure monitoring is not required.
随着便携式大容量数据记录设备和全自动计算机分析技术的发展，现在已能够在门诊患者动态环境中及完整的昼夜周期内监测食管动力。然而，关于健康受试者食管动力的特征和模式，尤其是进餐的影响，现有数据有限。我们使用一个间隔5厘米的包含三个微型压力传感器的探头，研究了食物类型（液体与固体）以及标准化饮食与非标准化饮食对17名健康志愿者的影响。所有受试者遵循相同的饮食方案：标准化早餐、严格的液体午餐，晚餐的成分和数量不限。分析收缩事件的特征（幅度、持续时间、速度、斜率、曲线下面积）及其传播类型（蠕动、同步、节段性、逆行），并与仰卧期和餐间期进行比较。三种类型的餐食的收缩特征和传播模式相同。与餐间期和仰卧期相比，三种类型的餐食均显示出较高百分比的蠕动收缩和较低百分比的同步收缩。然而，个体收缩特征并无显著差异。仰卧期发现的同步、逆行和节段性收缩百分比高于进食期或餐间期。本研究表明，不同成分和数量餐食的食管收缩特征和传播模式相似。与餐间期和仰卧期相比，餐食始终主要以蠕动收缩为特征。因此，在长时间动态压力监测期间无需对餐食进行标准化。
