Gastroesophageal Junction Smooth Muscle Remodeling after Endoluminal Gastroplication
Gastroesophageal Junction Smooth Muscle Remodeling after Endoluminal Gastroplication
复制标题
腔内胃折叠术后胃食管连接部平滑肌重塑
DOI：
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发表时间：
2004
影响因子：
9.8
通讯作者：
J. Saltzman
中科院分区：
文献类型：
--
作者：
Julia J. Liu;J. Glickman;D. Carr;D. Brooks;J. Saltzman
内镜下胃折叠术（ELGP）是一种治疗胃食管反流病的内镜下粘膜折叠术。粘膜缝合的抗反流机制仍然知之甚少。本研究的目的是调查任何形态学的变化，在平滑肌层引起的粘膜缝合放置在gastroesophageal junctions.METHODS：ELGPs进行使用内窥镜下放置两个或三个环周缝合线的squamocolumnar交界处2厘米内的设备。随后症状缓解的8例患者接受了内镜超声（EUS），以评价胃食管交界处的固有肌层。采用猪模型进行EUS和组织病理学相关性研究。结果：在8例症状缓解的患者中，胃食管交界处平滑肌层增厚（2.3 ± 0.4mm vs 1.4 ± 0.3mm，p < 0.01），其中15例为ELGP猪，而6例为对照猪。在ELGP猪中，通过EUS，缝合部位附近的平滑肌层厚度增加了2.6 mm。通过组织学，总的和环形平滑肌层厚度增加了2.1毫米和1.9毫米，分别。结论：局灶性增厚的平滑肌层发生在胃食管交界处ELGP后，胃食管反流病患者。这一发现在猪模型中重现，发现局部肥大完全是由于环形平滑肌层增加所致。
OBJECTIVES:Endoluminal gastroplication (ELGP) is an endoscopic mucosal suturing procedure for the treatment of gastroesophageal reflux disease. The antireflux mechanism of the mucosal suture remains poorly understood. The aim of this study is to investigate any morphologic changes in the smooth muscle layer induced by the mucosal sutures placed at the gastroesophageal junction.METHODS:ELGPs were performed using endoscopic suturing devices with placement of two or three circumferential sutures within 2 cm of the squamocolumnar junction. Eight patients with subsequent symptom resolution underwent endoscopic ultrasound (EUS) to evaluate the muscularis propria layer at the gastroesophageal junction. A swine model was used for EUS and histopathologic correlation study. Six control and 15 ELGP pigs were evaluated with EUS and histological examination of the gastroesophageal junction smooth muscle layer.RESULTS:Focal thickening of the muscularis propria layer near the suture region (2.3 ± 0.4 mm vs 1.4 ± 0.3 mm, p < 0.01) was found in eight patients with symptomatic resolution. In ELGP pigs, the smooth muscle layer thickness increased by 2.6 mm near the suture site by EUS. By histology, the total and circular smooth muscle layer thickness increased by 2.1 mm and 1.9 mm, respectively.CONCLUSIONS:Focal thickening of smooth muscle layer occurs at the gastroesophageal junction after ELGP in patients with gastroesophageal reflux disease. This finding was reproduced in a swine model and localized hypertrophy was found to be entirely due to an increase in the circular smooth muscle layer.
高血压中的平滑肌细胞肥大与增生。
DOI：
10.1073/pnas.78.12.7759
发表时间：
1981
影响因子：
11.1
作者：
Owens,GK;Rabinovitch,PS;Schwartz,SM
通讯作者：
Schwartz,SM