Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation.
Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation.
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DOI：
10.1038/ajg.2008.150
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发表时间：
2009-02
影响因子：
9.8
通讯作者：
Pandolfino, John E.
中科院分区：
文献类型：
--
作者：
Kwiatek, Monika A.;Mirza, Faiz;Kahrilas, Peter J.;Pandolfino, John E.
虽然球感是一种常见的症状，但其发病机制尚不清楚。本研究的目的是量化的时间和幅度上食管括约肌（UES）的压力与高分辨率测压（HRM）的呼吸变化的患者有球感，正常对照组和胃食管反流病（GERD）患者没有球感。HRM记录从下咽部到胃进行了分析，在131个连续的球症患者正常（64）和异常（67）远端食管动力。在吞咽10 5 ml水之前分析静息UES压力长达5 min。比较了68例对照组和46例无气球的GERD患者的UES压力变化、吸气和呼气之间的平均幅度和最低UES舒张压。在对照组和患者中，UES压力通常在吸气期间增加。与对照组（10.6 mm Hg）和GERD患者（13.0 mm Hg）相比，球症患者（37.3 mm Hg）的静息UES压的呼吸相关变化显着放大（P < 0.0001）。UES压力>27 mm Hg的呼吸变化见于> 60%的球蛋白患者和<15%的对照组和无球蛋白的GERD患者。这种高动力UES与其他食管运动功能异常无关。高动力性呼吸UES压力变化在报告有球形感的患者中普遍存在，而与其吞咽UES和远端食管动力无关。虽然这种高动力UES的病因尚不清楚，但它似乎是该患者组中常见的测压观察结果，并可能为进一步研究发病机制和治疗提供新的焦点。
Although globus sensation is a common symptom, its pathogenesis is poorly defined. The aim of this study was to quantify the timing and magnitude of respiratory variation in upper esophageal sphincter (UES) pressure with high-resolution manometry (HRM) in patients with globus sensation, normal controls, and gastroesophageal reflux disease (GERD) patients without globus sensation. HRM recordings spanning from the hypopharynx to the stomach were analyzed in 131 consecutive globus patients with normal (64) and abnormal (67) distal esophageal motility. Resting UES pressure was analyzed up to 5 min before 10 5-ml water swallows. Change in UES pressure, its average magnitude between inspiration and expiration, and nadir UES relaxation pressure in globus patients were compared with those in 68 controls and 46 GERD patients without globus. UES pressure typically increased during inspiration in both controls and patients. Respiration-related change in resting UES pressure was significantly amplified in globus patients (37.3 mm Hg) compared with controls (10.6 mm Hg) and GERD patients (13.0 mm Hg) (P < 0.0001). A respiratory change in UES pressure >27 mm Hg was found in > 60% of globus patients and <15% of controls and GERD patients without globus. This hyperdynamic UES was not associated with other abnormalities of esophageal motor function. Hyperdynamic respiratory UES pressure changes were prevalent in patients reporting globus sensation irrespective of their deglutitive UES and distal esophageal motility. Although the etiology of this hyperdynamic UES is unclear, it does appear to be a frequent manometric observation in this patient group and may provide a new focus for further studies into pathogenesis and therapy.
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影响因子：
1.4
作者：
CALDARELLI, DD;ANDREWS, AH;DERBYSHIRE, AJ
通讯作者：
DERBYSHIRE, AJ
影响因子：
3.1
作者：
Corso, MJ;Pursnani, KG;Castell, DO
通讯作者：
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影响因子：
9.8
作者：
Pandolfino, John E.;Kim, Hyon;Kahrilas, Peter J.
通讯作者：
Kahrilas, Peter J.
影响因子：
2.6
作者：
PRATT, LW;TOBIN, WH;GALLAGHER, RA
通讯作者：
GALLAGHER, RA
影响因子：
1.7
作者：
PUHAKKA, H;LEHTINEN, V;AALTO, T
通讯作者：
AALTO, T