Dysfunction of the longitudinal muscles of the oesophagus in eosinophilic oesophagitis
Dysfunction of the longitudinal muscles of the oesophagus in eosinophilic oesophagitis
复制标题
DOI：
10.1136/gut.2008.168146
复制
发表时间：
2009-08-01
期刊：
影响因子：
24.5
通讯作者：
Mittal, R. K.
中科院分区：
文献类型：
--
作者：
Korsapati, H.;Babaei, A.;Mittal, R. K.
背景：大多数嗜酸性食管炎（EO）患者的食管动力（测压法）正常。然而，测压法仅测量食管的环形肌功能。本研究的目的是评估循环和纵向的肌肉功能，在吞咽引起的吞咽障碍的患者EO。方法：超声成像和测压同时收购EO和对照组的纵向肌肉和循环肌肉收缩，分别在吞咽引起的吞咽障碍。一个探头与超声换能器被定位2厘米，然后10厘米以上的下食管括约肌和5，5毫升的水吞咽记录之前和之后edrophonium.Results：有没有差异，在发病率的吞咽引起的pestulsis和测压压力（标志的环形肌肉收缩）之间的控制和患者EO。然而，在食管下括约肌上方2 cm和10 cm处，EO患者的肌肉厚度（纵向肌肉收缩的标志物）变化显著减少。EO患者的纵向肌肉反应明显减弱。正常受试者表现出同步性之间的环形和纵向肌肉收缩，受到edrophonium的影响。另一方面，EO患者表现出轻微的吞咽引起的收缩，不改变edrophonium.Conclusions：在EO患者中，有选择性功能障碍的纵向肌肉收缩过程中吞咽引起的收缩。这表明，纵向肌肉功能障碍，在EO可能有助于吞咽困难。
Background: Oesophageal motility, as measured by manometry, is normal in the majority of patients with eosinophilic oesophagitis (EO). However, manometry measures only the circular muscle function of the oesophagus. The goal of the present study was to assess circular and longitudinal muscle function during peristalsis in patients with EO.Methods: Ultrasound imaging and manometry were simultaneously acquired during swallow-induced peristalsis in patients with EO and controls to measure the longitudinal muscle and circular muscle contraction, respectively. A probe with an ultrasound transducer was positioned 2 cm and then 10 cm above the lower oesophageal sphincter and five, 5 ml water swallows were recorded before and after edrophonium.Results: There is no difference in the incidence of swallow-induced peristalsis and manometric pressures (a marker of circular muscle contraction) between controls and patients with EO. However, changes in the muscle thickness (a marker of longitudinal muscle contraction) are markedly diminished in patients with EO, at both 2 and 10 cm above the lower oesophageal sphincter. The longitudinal muscle response to edrophonium is markedly blunted in patients with EO. Normal subjects demonstrate synchrony between the circular and longitudinal muscle contraction during peristalsis that is affected by edrophonium. On the other hand, patients with EO demonstrate mild asynchrony of circular and longitudinal muscle contraction during swallow-induced contractions that is not altered by edrophonium.Conclusions: In patients with EO, there is selective dysfunction of the longitudinal muscle contraction during peristalsis. It is proposed that the longitudinal muscle dysfunction in EO may contribute to dysphagia.