Oesophageal peristaltic transition zone defects: real but few and far between.
Oesophageal peristaltic transition zone defects: real but few and far between.
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DOI：
10.1111/j.1365-2982.2008.01169.x
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发表时间：
2008-12
影响因子：
3.5
通讯作者：
Kahrilas PJ
中科院分区：
文献类型：
--
作者：
Ghosh SK;Pandolfino JE;Kwiatek MA;Kahrilas PJ
本研究分析了食道过渡带（TZ）缺陷（以食道近端（横纹肌）收缩末端与食道远端（平滑肌）收缩起始端之间的延迟和/或空间间隙为特征）与大量患者队列中吞咽困难之间的关系。采用36通道高分辨率测压仪（HRM）对400名连续患者（178名吞咽困难患者）和75名对照组进行了研究。首先利用75名对照者的正常值分析由此产生的压力地形图是否存在食管胃交界（OGJ）松弛受损、远端节段收缩异常和近端收缩异常。如果食管运动的这些方面被认为是正常的，那么TZ的特征是近端和远端收缩之间的长度和持续时间，使用20mmhg等压等高线来建立节段边界。然后根据患者是否表现出TZ缺陷（空间分离或延迟）和出现原因不明的吞咽困难进行分类。在400例患者中，267例适合进行TZ分析，其中55例的空间或时间TZ测量值超过对照组的第95百分位数（2 cm, 1 s）。有空间和/或时间颞部缺损的患者（n = 19）中有34.6%出现无法解释的吞咽困难，明显高于颞部尺寸正常的患者（19.8%）。虽然远不如远端蠕动或OGJ异常常见，但TZ缺陷可能与少数患者（<4%）的吞咽困难有关，应被视为一种独特的食管运动障碍。
This study analysed the association between oesophageal transition zone (TZ) defects [characterized by a delay and/or spatial gap between the terminus of the proximal oesophageal (striated muscle) contraction and the initiation of the distal oesophageal (smooth muscle) contraction] and dysphagia in a large patient cohort. Four hundred consecutive patients (178 with dysphagia) and 75 controls were studied with 36-channel high-resolution manometry (HRM). The resultant pressure topography plots were first analysed for impaired oesophagogastric junction (OGJ) relaxation, distal segment contractile abnormalities, and proximal contractile abnormalities using normal values from the 75 controls. If these aspects of oesophageal motility were deemed normal, the TZ was characterized by length and duration between the proximal and distal contractions using a 20 mmHg isobaric contour to establish the segment boundaries. Patients were then classified according to whether or not they exhibited TZ defects (spatial separation or delay) and the occurrence of unexplained dysphagia. Of the 400 patients, 267 were suitable for TZ analysis and of these 55 had a spatial or temporal TZ measurement exceeding the 95th percentile of the controls (2 cm, 1 s). Exactly 34.6% of the patients (n = 19) with spatial and/or temporal TZ defects had unexplained dysphagia, which was significantly more than seen with normal TZ dimensions (19.8%). Although far less common than distal peristaltic or OGJ abnormailites, TZ defects may be related to dysphagia in a minority of patients (<4% in this series) and should be considered a distinct oesophageal motility disorder.
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DOI：
10.1152/ajpgi.00510.2005
发表时间：
2006-05-01
影响因子：
4.5
作者：
Ghosh, SK;Pandolfino, JE;Kahrilas, PJ
通讯作者：
Kahrilas, PJ
影响因子：
29.4
作者：
Clouse, RE;Staiano, A;Alrakawi, A
通讯作者：
Alrakawi, A
DOI：
10.1152/ajpgi.00252.2007
发表时间：
2007-10-01
影响因子：
4.5
作者：
Ghosh, Sudip K.;Pandolfino, John E.;Kahrilas, Peter J.
通讯作者：
Kahrilas, Peter J.
影响因子：
7.6
作者：
Fox, M.;Menne, D.;Schwizer, W.
通讯作者：
Schwizer, W.
影响因子：
--
作者：
CLOUSE, RE;STAIANO, A
通讯作者：
STAIANO, A