Weak peristalsis in esophageal pressure topography: classification and association with Dysphagia.
Weak peristalsis in esophageal pressure topography: classification and association with Dysphagia.
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DOI：
10.1038/ajg.2010.384
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发表时间：
2011-02
影响因子：
9.8
通讯作者：
Kahrilas, Peter J.
中科院分区：
文献类型：
--
作者：
Roman, Sabine;Lin, Zhiyue;Kwiatek, Monika A.;Pandolfino, John E.;Kahrilas, Peter J.
食管测压常用于评估虚弱性食管炎。尽管临床上常用，但目前尚没有经验证的高分辨率食管压力地形图（EPT）中的弱收缩指标。本研究旨在通过对对照组和不明原因非梗阻性吞咽困难患者的比较分析，制定EPT中弱吞咽障碍的分类。在16名对照受试者中进行了高分辨率食管压力地形图（高分辨率阻抗测压）研究，以验证与不完全团注传输（IBT）相关的EPT特征。在计算机模拟中叠加EPT图的技术被用来推导另75名对照受试者的EPT蠕动完整性的正常限值。然后比较对照组和113例从大型临床系列中确定的非阻塞性吞咽困难患者的关键EPT缺陷的发生率。IBT的发生伴随着破裂失败或EPT图中近端或远端压力谷处20 mm Hg等压轮廓的断裂。等压线断裂的正常范围为0- 20%，大断裂（> 5 cm），0- 30%，小断裂（2-5 cm），这两种情况在吞咽困难患者中发生的频率明显更高。吞咽困难患者中，失败的吞咽并不常见。根据20 mm Hg等压面上出现的破裂，提出了一种适用于EPT的弱破裂分类法，其中大破裂的弱破裂定义为发生在> 20%的吞咽中，小破裂的弱破裂定义为发生在> 30%的吞咽中。
Esophageal manometry is frequently used to assess for weak peristalsis. Although commonly used clinically, there are currently no validated metrics of weak peristalsis in high-resolution esophageal pressure topography (EPT). This study aimed to develop a classification of weak peristalsis in EPT based on a comparative analysis of control subjects and patients with unexplained non-obstructive dysphagia. High-resolution esophageal pressure topography (high-resolution impedance manometry) studies were carried out in 16 control subjects to verify EPT features associated with incomplete bolus transit (IBT). The technique of superimposing EPT plots in a computer simulation was used to derive normal limits of peristaltic integrity in EPT in another 75 control subjects. The occurrence of critical EPT defects was then compared between control subjects and 113 patients with non-obstructive dysphagia identified from a large clinical series. IBT occurred with failed peristalsis or with breaks in the 20 mm Hg isobaric contour occurring at the proximal or distal pressure troughs in EPT plots. The normal range for isobaric contour breaks was 0–20 % for large (> 5 cm) and 0–30 % for small (2–5 cm) breaks, with both occurring significantly more frequently in dysphagic patients. Failed peristalsis was not more frequent in dysphagic patients. A classification of weak peristalsis adapted to EPT is proposed based on the occurrence of breaks in the 20 mm Hg isobaric contour wherein weak peristalsis with large breaks is defined by those occurring with > 20 % of swallows and weak peristalsis with small breaks defined by those occurring with > 30 % of swallows.
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影响因子：
3.5
作者：
Tutuian, R;Elton, JP;Katz, PO
通讯作者：
Katz, PO
影响因子：
3.5
作者：
Pandolfino, J. E.;Leslie, E.;Kahrilas, P. J.
通讯作者：
Kahrilas, P. J.
影响因子：
24.5
作者：
Sifrim, D;Silny, J;Janssens, JJ
通讯作者：
Janssens, JJ
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作者：
Nguyen, NQ;Rigda, R;Holloway, RH
通讯作者：
Holloway, RH
影响因子：
3.5
作者：
Pandolfino JE;Fox MR;Bredenoord AJ;Kahrilas PJ
通讯作者：
Kahrilas PJ