Swallowing in myotonic muscular dystrophy: A videofluoroscopic study
Swallowing in myotonic muscular dystrophy: A videofluoroscopic study
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DOI：
10.1053/apmr.2001.23962
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发表时间：
2001-07-01
影响因子：
4.3
通讯作者：
McKenzie, S
中科院分区：
文献类型：
--
作者：
Leonard, RJ;Kendall, KA;McKenzie, S
目的：（1）确定强直性肌营养不良症（MD）患者的吞咽功能与健康对照者的吞咽功能有何不同，（2）确定改善的贡献者和预测因素，（3）评估促进吞咽的策略。设计：观察。设置：大学医学中心。参与者：18名肌强直性MD成人（年龄范围，24- 58岁）和60名健康成人对照受试者（年龄范围，18- 73岁）。干预措施：吞咽促进策略。主要结果测量：组间比较平均团注通过时间、吞咽姿势的开始和通过动态侧视视频透视获得的位移测量值。结果：MD患者的团注通过时间显著较长，并且一些吞咽姿势的开始显著延迟。食管上括约肌开放时间延长（肌强直性MD，.61 +/-.13s;对照组，.5 +/-.11s）。肌强直性MD男性患者的舌骨移位（1.9 +/-.05cm）显著低于男性对照组（2.4 +/- .68cm）;在对照组和肌强直性MD女性患者之间未观察到这种差异。特别重要的是，在MD group.Conclusions中发现咽部收缩明显减少：与疾病相关的虚弱，而不是肌强直，是最重要的贡献者减值。可通过测量咽部面积来识别存在误吸风险的人员。选择促进咽部清洁的策略是值得的。
Objectives: (1) To determine how swallow function in patients with myotonic muscular dystrophy (MD) differs from that of healthy controls, (2) to identify the contributors to and predictors of improvement, and (3) to evaluate strategies that facilitate swallowing.Design: Observational.Setting: University medical center.Participants: Eighteen adults with myotonic MD (age range, 24-58yr) and 60 healthy adult control subjects (age range, 18-73yr).Interventions: Swallow facilitation strategies.Main Outcome Measures: Between-group comparisons of mean bolus transit times, onsets of swallow gestures, and displacement measures obtained by dynamic lateral view videofluoroscopy,Results: The MD patients' bolus transit times were significantly longer, and onsets of some swallow gestures were significantly delayed. Upper esophageal sphincter opening was prolonged (myotonic MD,.61 +/-.13s; control,.5 +/-.11s). Hyoid displacement was significantly less in men with myotonic MD (1.9 +/-.05cm) than in male controls (2.4 +/- .68cm); this difference was not observed between control and myotonic women. Of particular importance was the markedly reduced pharyngeal constriction found in the MD group.Conclusions: Weakness associated with the disease, as opposed to myotonia, was the most significant contributor to impairment. Persons at risk for aspiration may be identified by a measure of pharyngeal area. Selected strategies to facilitate pharyngeal clearing are worthwhile.