Quantifying esophageal peristalsis with high-resolution manometry: a study of 75 asymptomatic volunteers
Quantifying esophageal peristalsis with high-resolution manometry: a study of 75 asymptomatic volunteers
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DOI：
10.1152/ajpgi.00510.2005
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发表时间：
2006-05-01
影响因子：
4.5
通讯作者：
Kahrilas, PJ
中科院分区：
文献类型：
--
作者：
Ghosh, SK;Pandolfino, JE;Kahrilas, PJ
高分辨率测压（HRM）的空间分辨率大大增强，使其能够同时监测整个食管长度上的收缩活动。本研究的目的是确定新的HRM范式中食管癌的基本特征，并建立其规范价值。在75名无症状对照者中记录了10次5 ml水吞咽，其中固态测压组件包含36个间隔1 cm的圆周传感器，用于记录从下咽部到胃的位置。然后对数据集进行密集的计算分析，以提取出正常乳腺癌的基本特征。食管狭窄的概念是近端收缩、远端收缩和分隔两者的过渡区。对每个收缩段的长度进行量化，然后在受试者之间进行标准化，以总结收缩幅度和传播速度的局部波动。此外，分离近端和远端收缩的过渡区的时间和空间特征进行了量化。对于每个范例，绘制了图形，建立了中位数沿着以及观察到的变异的第5至第95百分位数范围。此外，使用流出道允许压力梯度的新概念分析了食管胃连接部松弛和食管胃连接部松弛之间的同步性。我们进行了详细的分析，旨在量化其基本特征，并在这样做，设计了新的范式，量化蠕动功能，希望将优化HRM在临床和调查研究中的效用。
The vastly enhanced spatial resolution of high-resolution manometry (HRM) makes it possible to simultaneous monitor contractile activity over the entire length of the esophagus. The aim of this investigation was to define the essential features of esophageal peristalsis in novel HRM paradigms and establish their normative values. Ten 5-ml water swallows were recorded in each of 75 asymptomatic controls with a solid-state manometric assembly incorporating 36 circumferential sensors spaced at 1-cm intervals positioned to record from the hypopharynx to the stomach. The data set was then subjected to intensive computational analysis to distill out the essential characteristics of normal peristalsis. Esophageal peristalsis was conceptualized in terms of a proximal contraction, a distal contraction, and a transition zone separating the two. Each contractile segment was quantified in length and then normalized among subjects to summarize focal fluctuation of contractile amplitude and propagation velocity. Furthermore, the temporal and spatial characteristics of the transition zone separating the proximal and distal contraction were quantified. For each paradigm, graphics were developed, establishing median values along with the 5th to 95th percentile range of observed variation. In addition, the synchronization between peristalsis and esophagogastric junction relaxation was analyzed using a novel concept of the outflow permissive pressure gradient. We performed a detailed analysis of esophageal peristalsis aimed at quantifying its essential features and, in so doing, devised new paradigms for the quantification of peristaltic function that will hopefully optimize the utility of HRM in clinical and investigative studies.