Topographic analysis of esophageal double-peaked waves
Topographic analysis of esophageal double-peaked waves
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DOI：
10.1016/s0016-5085(00)70252-6
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发表时间：
2000-03-01
期刊：
影响因子：
29.4
通讯作者：
Alrakawi, A
中科院分区：
文献类型：
--
作者：
Clouse, RE;Staiano, A;Alrakawi, A
背景与目的：食管双峰波在功能性食管症状患者中出现的频率增加。进行这项研究是为了进一步了解负责其生产的机制。研究方法：地形图的方法，考虑时间和空间关系的压力数据被用来检查74双峰波检测在18名受试者提到的原因不明的症状的测压评估。这些研究是用为地形图绘制而设计的计算机化数据采集和分析系统进行的。结果如下：第二个峰似乎代表肌肉收缩，与第三地形图节段中异常强的压力部位合并，覆盖该部位近端6.3 +/- 1.6 cm（33.5% +/- 8.5%食管长度）。在50例吞咽（67.6%）中，峰值本身以13.2 +/- 10.8 cm/s的速度逆行进展，表明强烈远端运动事件的头部延伸。波的发作和运动的分析：在蠕动后缘检测到逆行传播高达33.8%的波，顺行传播2.7%，并在其余的同时收缩。结论：在有症状的患者中，双峰波中的第二峰通常是在远端食管体中的第三地形段的区域中并与第三地形段合并的短的、同时的或逆行的压力事件。地形图方法有助于解释这些波形与食管远端过度收缩的其他特征的共同关联，并表明它们与抑制神经功能不足的关系。
Background & Aims: Esophageal double-peaked waves occur with increased frequency in patients with functional esophageal symptoms. This study was undertaken to further understand the mechanisms responsible for their production. Methods: Topographic methods that consider temporal and spatial relationships of pressure data were used to examine 74 double-peaked waves detected in 18 subjects referred for manometric evaluation of unexplained symptoms. The studies were performed with a computerized data acquisition and analysis system designed for topographic plotting. Results: The second peak appeared to represent muscle contraction that merged with an unusually strong pressure site in the third topographic segment and covered 6.3 +/- 1.6 cm (33.5% +/- 8.5% esophageal length) proximal to this site. In 50 swallows (67.6%), the peak itself progressed in a retrograde direction at 13.2 +/- 10.8 cm/s, suggesting cephalad extension of a strong distal motor event. Analysis of wave onsets and movement: of the peristaltic trailing edge detected retrograde propagation in up to 33.8% of waves, antegrade propagation in 2.7%, and simultaneous contraction in the remainder. Conclusions: In symptomatic patients, the second peak in a double-peaked wave is typically a short, simultaneous, or retrograde pressure event in the region of and merging with the third topographic segment in the distal esophageal body. Topographic methods help explain the common association of these waveforms with other features of exaggerated contraction in the distal esophagus and suggest their relationship to inadequate inhibitory nerve function.