The Manometric Representation of the Upper Esophageal Sphincter During the Resting State: A Descriptive Study.
The Manometric Representation of the Upper Esophageal Sphincter During the Resting State: A Descriptive Study.
复制标题
DOI：
10.1007/s00455-023-10615-9
复制
发表时间：
2023-08
期刊：
影响因子：
2.6
通讯作者：
Sophia M. Colevas;L. Stalter;Corinne A. Jones;T. McCulloch
中科院分区：
文献类型：
--
作者：
Sophia M. Colevas;L. Stalter;Corinne A. Jones;T. McCulloch
食管上括约肌（UES）是下咽和食管之间过渡的高压区。使用咽部高分辨率测压（HRM）进行静息UES的研究有限，现有的规范性数据差异很大。本研究描述了使用临床上可获得的测量方法对静息UES进行测压表示。从咽部HRM标准数据库中的87例受试者中获得数据，同时进行视频透视。确定静息UES测压区域，并在整个研究期间使用测压软件中的Smart Mouse功能采集该区域的10个测量节段。组内相关系数（ICC）用于分析跨测量的受试者内可靠性。线性混合效应回归模型用于分析受试者特征和测压条件如何影响静息UES压力。静息UES平均压力之间的受试者内可靠性极佳（ICC = 0.96）。在双变量分析中，年龄、静息UES内包含的传感器数量和先前吞咽量对平均静息UES压力有显著影响。年龄每增加1个单位，静息UES压降低0.19个单位（p= 0.008）。静息UES中包含的传感器数量每增加1个单位，静息UES压力增加3.71个单位（p< 0.001）。本研究采用全面且临床可及的方案提供了静息UES的规范性数据，该方案可为吞咽障碍人群（尤其是UES功能障碍）的研究提供标准比较，并为UES定向干预提供支持。
The upper esophageal sphincter (UES) is the high-pressure zone marking the transition between the hypopharynx and esophagus. There is limited research surrounding the resting UES using pharyngeal high-resolution manometry (HRM) and existing normative data varies widely. This study describes the manometric representation of the resting UES using a clinically accessible method of measurement. Data were obtained from 87 subjects in a normative database of pharyngeal HRM with simultaneous videofluoroscopy. The resting UES manometric region was identified and ten measurement segments of this region were taken throughout the duration of the study using the Smart Mouse function within the manometry software. Intraclass correlation coefficients (ICC) were used to analyze within-subject reliability across measurements. Linear mixed-effects regression models were used to analyze how subject characteristics and manometric conditions influence resting UES pressure. There was excellent within-subject reliability between resting UES mean pressures (ICC = 0.96). In bivariate analysis, there were significant effects of age, number of sensors contained within the resting UES, and preceding swallow volume on mean resting UES pressure. For every 1 unit increase in age, there was a 0.19 unit decrease in resting UES pressure (p= 0.008). For every 1 unit increase in number of sensors contained within the resting UES, there was a 3.71 unit increase in resting UES pressure (p< 0.001). This study presents normative data for the resting UES, using a comprehensive and clinically accessible protocol that can provide standard comparison for the study of populations with swallowing disorders, particularly UES dysfunction, and provides support for UES-directed interventions.