Esophageal distension during bolus transport: can it be detected by intraluminal impedance recordings?
Esophageal distension during bolus transport: can it be detected by intraluminal impedance recordings?
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DOI：
10.1111/nmo.12369
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发表时间：
2014-08-01
影响因子：
3.5
通讯作者：
Bhargava, V.
中科院分区：
文献类型：
--
作者：
Kim, J. H.;Mittal, R. K.;Bhargava, V.
背景食管多重腔内阻抗（MII）测量已被用于检测胃食管反流和弹丸传输。尚不清楚MII是否可以检测团注输送期间管腔横截面积（CSA）的变化。同时记录腔内超声（US）图像、MII和高分辨率测压（HRM），以确定食管推注输送期间CSA和阻抗之间的时间关系，并确定峰值扩张和最低阻抗之间的关系。方法对5名健康受试者进行研究。在LES上方6 cm处记录MII、HRM和US图像。在吞咽和向食管中注射0.5 N盐水推注期间研究食管扩张。关键结果食管CSA的时间变化与阻抗变化相关（r值：平均值+/- SD =-0. 80 +/-0. 08，范围：-0. 94至-0. 66）。扩张过程中阻抗的下降分为两个步骤;最初的大幅度下降与CSA开始增加相关，随后是小幅度下降，在此期间发生大部分CSA增加。峰值CSA和最低点阻抗发生在1 s内。增加吞咽量和注射量会增加CSA，对大滴无影响，但会增加小滴振幅。我们观察到峰值CSA和最低点阻抗之间的显著相关性（r =-0.90，p < 0.001），峰值CSA和阻抗倒数之间的相关性更好（r =-0.94，p < 0.001）。结论和推论需要进一步的研究来证实，腔内阻抗记录可用于测量管腔CSA在食管弹丸运输。
Background Esophageal multiple intraluminal impedance (MII) measurement has been used to detect gastro-esophageal reflux and bolus transport. It is not clear if MII can detect changes in luminal cross sectional area (CSA) during bolus transport. Intraluminal ultrasound (US) images, MII, and high resolution manometry (HRM) were recorded simultaneously to determine temporal relationship between CSA and impedance during esophageal bolus transport and to define the relationship between peak distension and nadir impedance. Methods Studies were conducted in five healthy subjects. MII, HRM, and US images were recorded 6 cm above LES. Esophageal distensions were studied during swallows and injections of 0.5 N saline bolus into the esophagus. Key Results Temporal change in esophageal CSA correlates with changes in impedance (r-value: mean +/- SD = -0.80 +/- 0.08, range: -0.94 to -0.66). Drop in impedance during distension occurs as a two-step process; initial large drop associated with onset of CSA increase, followed by a small drop during which majority of the CSA increase occurs. Peak CSA and nadir impedance occur within 1 s of each other. Increase in swallow and injection volumes increased the CSA, had no effect on large drop but increased the small drop amplitude. We observed a significant correlation between peak CSA and nadir impedance (r = -0.90, p < 0.001) and a better correlation between peak CSA and inverse impedance (r = -0.94, p < 0.001). Conclusions & Inferences Further studies are needed to confirm that intraluminal impedance recordings may be used to measure luminal CSA during esophageal bolus transport.