Effects of position on oesophageal function: studies using combined manometry and multichannel intraluminal impedance
Effects of position on oesophageal function: studies using combined manometry and multichannel intraluminal impedance
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DOI：
10.1046/j.1365-2982.2003.00387.x
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发表时间：
2003-02-01
影响因子：
3.5
通讯作者：
Katz, PO
中科院分区：
文献类型：
--
作者：
Tutuian, R;Elton, JP;Katz, PO
多通道腔内阻抗(MII)可以评估食道内团注的传输。仰卧位时，推注传递几乎完全由蠕动收缩产生；在直立位置时，重力也有助于推注传递。使用10只燕子(每只5毫升)测量四个位置(0，30，60和90度)的MII和蠕动压力，体位由随机选择。分析总的团注通过时间：在下食道括约肌(LOS)上方20 cm处进入团注与在LOS上方5 cm处退出团团之间的时间间隔，以及在LOS上方5 cm和10 cm处的收缩幅度。用ANOVA和Bonnferoni后验对所有四种体位的平均值进行统计比较。10名正常受试者(5名女性和5名男性，年龄24-45岁)完成了这项研究。在每个身体位置，液体物质比粘性物质通过得更快(P<；0.001)。液体和粘性物质在低倾角(0°和30°)时的传输速度明显慢于大倾角(60°和90°)。液体(r=-0.99)和粘性(r=-1.00)丸剂的倾斜角与药丸通过时间之间几乎完全呈线性负相关(两种物质的Spearman相关系数r>；0.99和P<；0.02)。在给定的倾斜度下，液体和粘性物质的收缩幅度没有显著差异。食道远端平均波幅随倾斜度增加而降低。综合MII-OM确定并量化重力对OM测量的比压和MII测量的传递功能之间的二分性的影响。
Multichannel intraluminal impedance (MII) allows assessment of intraoesophageal bolus transit. In the supine position, bolus transit is produced almost exclusively by peristaltic contractions; in the upright position, gravity also contributes to bolus transit. MII and peristaltic pressures were measured in four positions (0, 30, 60 and 90degrees) using ten swallows (5 cc each) of both water and viscous liquid with body position determined by random choice. Tracings were analysed for total bolus transit time: time interval between bolus entry at 20 cm above and bolus exit at 5 cm above the lower oesophageal sphincter (LOS) and contraction amplitudes at 5 and 10 cm above the LOS. Statistical comparison of mean values of all four body positions was done using anova and Bonnferoni post-test. Ten normal subjects (five females and five males, age 24-45 years) completed the study. At each body position, liquid material transited faster (P < 0.001) than viscous material. Both liquid and viscous materials transited at lower inclinations (0 and 30°) significantly slower than at higher inclinations (60 and 90°). There was an almost perfect inverse linear correlation between angle of inclination and bolus transit time for both liquid (r = -0.99) and viscous (r = -1.00) boluses (Spearman correlation r > 0.99 and P < 0.02 for both substances). Contraction amplitudes for liquid vs viscous material were not significantly different at a given degree of inclination. Mean distal oesophageal amplitude declined with increasing inclination. Combined MII-OM identifies and quantifies the effects of gravity on the dichotomy between specific pressures measured by OM and function assessed as transit measured by MII.