Association between eosinophilic esophagitis and esophageal dysmotility: A systematic review and meta-analysis.
Association between eosinophilic esophagitis and esophageal dysmotility: A systematic review and meta-analysis.
复制标题
嗜酸性粒细胞性食管炎与食管运动障碍之间的关联：系统评价和荟萃分析。
DOI：
10.1111/nmo.14475
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Dellon,EvanS
中科院分区：
文献类型：
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作者：
Reddy,SumanaB;Ketchem,CoreyJ;Dougherty,MichaelK;Eluri,Swathi;Dellon,EvanS
背景关于嗜酸性粒细胞性食管炎（EOE）与食管动力障碍之间的联系，存在相互矛盾的证据。本研究的目的是评估食管测压结果EoE.MethodsWe进行了系统评价，使用PubMed，EMBASE，和Web的科学。1990年至2021年期间所有涉及接受食管测压的EoE患者的文章均合格。我们还收录了2015年至2020年国家会议的相关摘要。主要结局是EoE中特定芝加哥3分类（CCv 3）诊断的患病率，以及更广泛类别的非松弛性食管下括约肌以及主要和次要蠕动疾病。当多项研究报告了一个特定的结果时，我们进行了随机效应Meta分析，以获得每个结果的汇总患病率。为减少异质性，我们将Meta分析仅限于高分辨率测压（HRM）研究。关键结果在识别的763篇文献中，27项原始研究符合纳入标准，包括706例EoE患者; 14项研究（425例患者）进行了HRM并进行了Meta分析。任何运动异常的合并患病率为53%（95% CI：43%-63%），主要包括轻微的运动障碍，如无效的食管运动和碎片化的食管。根据CCv 3分类的主要动力障碍在EoE中较不常见，贲门失弛缓症、食管胃连接部流出道梗阻和收缩功能亢进疾病的合并患病率分别为2%（0%-7%）、10%（5%-16%）和1%（0%-3%）。需要进一步的研究来确定嗜酸性粒细胞浸润与该人群中食管动力异常的临床相关性。
BackgroundThere is conflicting evidence about the association between eosinophilic esophagitis (EoE) and esophageal motility disorders. The aim of this study was to evaluate esophageal manometry findings in EoE.MethodsWe conducted a systematic review using PubMed, EMBASE, and Web of Science. All articles from 1990 to 2021 with EoE patients who underwent esophageal manometry were eligible. We also included pertinent abstracts from national conferences from 2015 to 2020. The primary outcomes were the prevalence of specific Chicago 3 Classification (CCv3) diagnoses in EoE, as well as broader categories of non‐relaxing lower esophageal sphincter, and major and minor peristaltic disorders. When multiple studies reported a specific outcome, we performed random effects meta‐analysis to obtain pooled prevalence of each outcome. To reduce heterogeneity, we restricted meta‐analysis to high‐resolution manometry (HRM) studies only.Key ResultsOf 763 publications identified, 27 original studies met criteria for inclusion, encompassing 706 EoE patients; 14 studies (425 patients) had HRM and underwent meta‐analysis. The pooled prevalence of any motility abnormality was 53% (95% CI: 43%–63%), largely comprised of minor motility disorders such as ineffective esophageal motility and fragmented peristalsis. Major motility disorders, classified by CCv3, were less common in EoE, with pooled prevalence of 2% (0%–7%), 10% (5%–16%), and 1% (0%–3%), for achalasia, esophagogastric‐junction outflow obstruction, and hypercontractile disorders, respectively.Conclusion and InferencesNon‐specific motility disorders were common in patients with EoE, but major motility disorders were rare. Further studies are needed to determine the relationship between eosinophilic infiltration and the clinical relevance of abnormal esophageal motility findings in this population.