Intersubject and interswallow variability in topography of esophageal motility
Intersubject and interswallow variability in topography of esophageal motility
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DOI：
10.1023/a:1018838710214
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发表时间：
1998-09-01
影响因子：
3.1
通讯作者：
Staiano, A
中科院分区：
文献类型：
--
作者：
Clouse, RE;Alrakawi, A;Staiano, A
地形图连接平均测压数据的时间和空间表明，连续的收缩段形成食管扩张。一个系统能够绘制个人吞咽验证这一观察，并确定受试者和interswallow的地形外观的变化。14名志愿者进行了研究，一种新的计算机同化方法能够生成地形等高线图，以及传统的波形进行分析。在所有受试者中，近端体部和下括约肌的收缩段与食管的其余部分分离，吞咽间变化很小。通过远端体的痉挛的外观是更可变的，因为其间歇性分离成两个占主导地位的收缩段（59.8%的吞咽），具有较差的相关性收缩强度（中位数r = 0.15）。受试者间变异性超过了吞咽间变异性的地形标志，导致独特的地形“指纹”的每个主题的吞咽障碍。我们得出结论，地形图绘制的单吞咽是可行的，并确认存在连续收缩段食管。吞咽间变异性有助于证明平滑肌体内的两个部分，这是一个看似同质的解剖区域，具有足够的收缩独立性，以指示对不同收缩影响做出反应的独立神经肌肉单位。
Topographic plots linking averaged manometric data in time and space suggest that sequential contraction segments form esophageal peristalsis. A system capable of plotting individual swallows was developed to verify this observation and to determine intersubject and interswallow variability in their topographic appearance. Fourteen volunteers were studied with a novel computerized assimilation method capable of generating topographic contour plots as well as conventional wave forms for analysis. Contraction segments in the proximal body and lower sphincter were identified in all subjects as being separate from the remainder of the esophagus with little interswallow variation. The appearance of peristalsis through the distal body was more variable because of its intermittent separation into two dominant contraction segments (59.8% of swallows) that had poorly correlated contraction strength (median r = 0.15). Intersubject variability exceeded interswallow variability in topographic landmarks, resulting in distinctive topographic "fingerprints" of peristalsis for each subject. We conclude that topographic plotting of single swallows is feasible and confirms the presence of sequential contraction segments in the esophagus. Interswallow variability helps demonstrate two segments within the smooth-muscle body, an anatomical region of seeming homogeneity, that have sufficient contraction independence to indicate separate neuromuscular units responding to different contractile influences.