Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm
Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm
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DOI：
10.1152/ajpgi.00365.2001
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发表时间：
2002-06-01
影响因子：
4.5
通讯作者：
Mittal, RK
中科院分区：
文献类型：
--
作者：
Pehlivanov, N;Liu, JM;Mittal, RK
我们以前在正常受试者中发现，食管收缩幅度和峰值肌肉厚度之间呈正相关。本研究的目的是确定食管肌肉厚度与高振幅蠕动和同时收缩患者的收缩振幅之间的关系。11例高振幅蠕动性收缩，8例弥漫性食管痉挛（DES），7例非特异性（NS）运动障碍的食管，和10名正常人进行了研究，同时使用压力和超声成像。通过测压和高频超声探头导管超声成像记录压力。在静息状态和吞咽诱导收缩期间，在食管下括约肌（LES）和LES上方2、4、6、8和10 cm处进行记录。在正常受试者和患者组中，与近端食管相比，远端的基线食管肌肉较厚。与正常和NS患者相比，DES和胡桃夹食管（NC）患者的基线肌肉厚度较高。与正常受试者和NS患者相比，NC和DES患者的峰值压力和峰值肌肉厚度之间的相关性较弱。而正常受试者之间有良好的相关性δ（峰值和基线之间的差异）肌肉厚度和峰值压力，这种关系是不存在的NC和DES患者。NC和DES患者收缩幅度的增加与食管固有肌层基线厚度的增加相关。基线厚度增加是痉挛性运动障碍患者特有的，在NS患者中未观察到。
We previously showed, in normal subjects, a positive correlation between the esophageal contraction amplitude and peak muscle thickness. The goal of this study was to determine the relationship between esophageal muscle thickness and contraction amplitude in patients with high-amplitude peristaltic and simultaneous contractions. Eleven patients with high-amplitude peristaltic contractions, 8 with diffuse esophageal spasm (DES), 7 with nonspecific (NS) motor disorder of the esophagus, and 10 normal subjects were studied using simultaneous pressure and ultrasound imaging. Pressure was recorded by manometry and ultrasound imaging with a high-frequency ultrasound probe catheter. Recordings were performed in the lower esophageal sphincter (LES) and at 2, 4, 6, 8, and 10 cm above the LES during resting state and swallow-induced contractions. Baseline esophageal muscle was thicker in the distal, compared with the proximal esophagus both in normal subjects and patient groups. Patients with DES and nutcracker esophagus (NC) have a higher baseline muscle thickness compared with normal and NS patients. Correlation between the peak pressure and the peak muscle thickness was weaker in patients with NC and DES compared with normal subjects and patients with NS. Whereas normal subjects have good correlation between delta (difference between peak and baseline) muscle thickness and peak pressures, this relationship was absent in patients with NC and DES. Increase in contraction amplitude in patients with NC and DES was associated with an increase in baseline thickness of esophageal muscularis propria. Increase in baseline thickness was specific to patients with spastic motor disorders and was not seen in patients with NS.