Prevalence of increased esophageal muscle thickness in patients with esophageal symptoms
Prevalence of increased esophageal muscle thickness in patients with esophageal symptoms
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DOI：
10.1111/j.1572-0241.2006.01003.x
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发表时间：
2007-01-01
影响因子：
9.8
通讯作者：
Mittal, Ravinder K.
中科院分区：
文献类型：
--
作者：
Dogan, Ibrahim;Puckett, James L.;Mittal, Ravinder K.
背景：贲门失弛缓症、弥漫性食管痉挛（DES）和胡桃夹食管患者的固有肌层比正常人厚。我们的研究的目的是确定一组食管功能实验室评价的symptoms.METHODS：我们研究了40名正常人和94名连续患者的肌肉厚度增加的患病率。使用特殊定制的导管同时记录测压和超声图像。在食管下括约肌（LES）上方2 cm和10 cm处测量食管肌肉厚度和肌肉横截面积。患者被分配测压诊断和确定，如果他们有增加的肌肉厚度和肌肉横截面积。结果：几乎所有的患者与明确的痉挛运动障碍，即，贲门失弛缓症、DES和胡桃夹食管，显示（a）肌肉厚度/横截面积增加，（B）在特征不太明确的测压异常患者中也观察到食管肌肉厚度/横截面积增加，尽管患病率较低，即，高血压LES、LES松弛受损和无效的食管运动，和（c）24%的有食管症状但测压正常的患者也发现肌肉厚度/横截面积增加。吞咽困难是更有可能的，和烧心不太可能增加肌肉厚度的患者，但有胸痛和反流症状groups.CONCLUSION之间没有差异：我们描述，第一次，增加食管症状和正常测压患者的肌肉厚度。我们认为食管肌厚度增加可能是食管运动功能障碍的一个重要标志。
BACKGROUND: Patients with achalasia, diffuse esophageal spasm (DES), and nutcracker esophagus have a thicker muscularis propria than normal subjects. The goal of our study was to determine the prevalence of increased muscle thickness in a group of unselected patients referred to the esophageal function laboratory for evaluation of the symptoms.METHODS: We studied 40 normal subjects and 94 consecutive patients. Manometry and ultrasound images were recorded concurrently, using a special custom-built catheter. Esophageal muscle thickness and muscle cross-sectional area were measured at 2 and 10 cm above the lower esophageal sphincter (LES). Patients were assigned manometric diagnosis and determination was made if they had increased muscle thickness and muscle cross-sectional area.RESULTS: Nearly all patients with well-defined spastic motor disorders, i.e., achalasia, DES, and nutcracker esophagus, revealed (a) an increase in the muscle thickness/cross-sectional area, (b) increase in esophageal muscle thickness/cross-sectional area was also seen, albeit at a lower prevalence rate, in patients with less well-characterized manometric abnormalities, i.e., hypertensive LES, impaired LES relaxation, and ineffective esophageal motility, and (c) 24% of patients with esophageal symptoms but normal manometry were also found to have an increase in muscle thickness/cross-sectional area. Dysphagia was more likely, and heartburn less likely in patients with increased muscle thickness, but there were no differences in chest pain and regurgitation symptoms between the groups.CONCLUSION: We describe, for the first time, increased muscle thickness in patients with esophageal symptoms and normal manometry. We suggest that increased esophageal muscle thickness is likely to be an important marker of esophageal motor dysfunction.