Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry.
Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry.
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DOI：
10.5535/arm.2017.41.5.776
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发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Yoon KJ
中科院分区：
文献类型：
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作者：
Park CH;Kim DK;Lee YT;Yi Y;Lee JS;Kim K;Park JH;Yoon KJ
采用高分辨率测压法（HRM）比较健康受试者和咽部吞咽困难患者的吞咽功能，并评价HRM检测咽部吞咽困难的有效性。本研究纳入了75例吞咽困难患者和28例健康受试者。吞咽困难的诊断通过视频透视得到证实。进行HRM以测量咽部（VP）、舌根（TB）和上食管括约肌（UES）的压力和时间信息。比较吞咽困难组和健康组的HRM参数。确定吞咽困难的重要HRM参数的最佳阈值。吞咽困难组VP最大压、TB最大压、UES舒张时间、UES静息压均低于健康组。吞咽困难组UES最小压力高于健康组。进行受试者工作特征（ROC）分析，以验证识别咽部吞咽困难患者的重要HRM参数的最佳阈值。当最大VP压力阈值为144.0 mmHg时，识别吞咽困难的灵敏度为96.4%，特异性为74.7%。当最大TB压力阈值为158.0 mmHg时，识别吞咽困难的敏感性为96.4%，特异性为77.3%。当UES最小压力阈值为2.0 mmHg时，诊断吞咽困难的敏感性为74.7%，特异性为60.7%。最后，UES舒张持续时间<0.58秒具有85.7%的敏感性和65.3%的特异性，UES静息压<75.0 mmHg具有89.3%的敏感性和90.7%的特异性，用于识别吞咽困难。我们提出的证据表明，HRM可能是一个有用的评估工具，用于检测咽部吞咽困难。
To compare swallowing function between healthy subjects and patients with pharyngeal dysphagia using high resolution manometry (HRM) and to evaluate the usefulness of HRM for detecting pharyngeal dysphagia. Seventy-five patients with dysphagia and 28 healthy subjects were included in this study. Diagnosis of dysphagia was confirmed by a videofluoroscopy. HRM was performed to measure pressure and timing information at the velopharynx (VP), tongue base (TB), and upper esophageal sphincter (UES). HRM parameters were compared between dysphagia and healthy groups. Optimal threshold values of significant HRM parameters for dysphagia were determined. VP maximal pressure, TB maximal pressure, UES relaxation duration, and UES resting pressure were lower in the dysphagia group than those in healthy group. UES minimal pressure was higher in dysphagia group than in the healthy group. Receiver operating characteristic (ROC) analyses were conducted to validate optimal threshold values for significant HRM parameters to identify patients with pharyngeal dysphagia. With maximal VP pressure at a threshold value of 144.0 mmHg, dysphagia was identified with 96.4% sensitivity and 74.7% specificity. With maximal TB pressure at a threshold value of 158.0 mmHg, dysphagia was identified with 96.4% sensitivity and 77.3% specificity. At a threshold value of 2.0 mmHg for UES minimal pressure, dysphagia was diagnosed at 74.7% sensitivity and 60.7% specificity. Lastly, UES relaxation duration of <0.58 seconds had 85.7% sensitivity and 65.3% specificity, and UES resting pressure of <75.0 mmHg had 89.3% sensitivity and 90.7% specificity for identifying dysphagia. We present evidence that HRM could be a useful evaluation tool for detecting pharyngeal dysphagia.