Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal reflux
Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal reflux
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DOI：
10.1023/a:1018862814873
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发表时间：
1998-07-01
影响因子：
3.1
通讯作者：
Castell, DO
中科院分区：
文献类型：
--
作者：
Corso, MJ;Pursnani, KG;Castell, DO
癔球症（globus）的最佳描述是喉咙里持续有肿块或饱胀感。尽管食管球症的病因尚不清楚，但其归因于食管上端括约肌（UES）静息压高血压和胃食管反流（GER）。因此，本研究的目的是确定球蛋白、UES 静息压和 GER 之间是否存在显着关联。我们回顾了所有每隔 2 1/2 年进行一次固定食管测压的患者的记录，特别关注癔球症状、UES 压力和动态 pH 值研究。患有低血压 UES (118 mm Hg) 的患者。 650 名患者中，有 17 名 (3%)（16 名女性/1 名男性；平均年龄：48 岁，范围 32-81 岁）患有正常 UES 描述的球状核。相反，101 名高血压 UES 患者中，有 28 名 (28%)（15 名女性/13 名男性；平均年龄：43，范围 23-61 岁）描述为球状。 UES 和球体的高渗性之间存在显着相关性 (chi(2) = 93.42，P < 0.0001）。在 UES 正常的患者中，球状病变主要发生在女性中（chi(2) = 6.33，P < 0.01）。 45 名癔球症患者中有 23 名（16 名女性/7 名男性；平均年龄：43 岁，范围 23-60 岁）之前进行过动态 pH 值研究。 23 人中有 6 人 (26%) 有 GER。与年龄、性别和 UES 压力匹配的 23 名无球蛋白患者组（16 名女性/7 名男性；平均年龄：44，范围 22-75 岁）相比，9 名 (39%) 患有 GER，因此显示球蛋白与 GER 没有显着相关性 (P = 0.35)。在这些患者中，GER 与正常 UES 或高血压 UES 也没有显着相关性。总之，高血压 UES 与球蛋白之间存在显着相关性。数据提示了两种可能的病因：UES 压力正常的女性患者可能传入感觉增加，以及性别分布相同但 UES 静息压异常升高的一组。这项研究不支持 GER 作为球状核的病因。
Globus sensation (globus) is best described as a constant feeling of a lump or fullness in the throat. Although the etiology of globus remains unclear, it has been attributed to a hypertensive upper esophageal sphincter (UES) resting pressure and to gastroesophageal reflux (GER). The aim of this study was, therefore, to determine if significant associations existed among globus, UES resting pressure, and GER. We reviewed the records of all patients who had stationary esophageal manometry over a 2 1/2-year interval with specific attention to symptoms of globus, UES pressures, and ambulatory pH studies. Patients with hypotensive UES (118 mm Hg). Seventeen of the 650 (3%) (16 women/1 man; mean age: 48, range 32-81 years) with normal UES described globus. Conversely, 28 of the 101 (28%) (15 women/13 men; mean age: 43, range 23-61 years) patients with hypertensive UES described globus. There was a significant association between hypertonicity of the UES and globus (chi(2) = 93.42, P < 0.0001). In patients with normal UES, globus occurred predominantly in females (chi(2) = 6.33, P < 0.01). Twenty-three (16 women/7 men; mean age: 43, range 23-60 years) of the 45 patients with globus had prior ambulatory pH studies. Six of 23 (26%) had GER. Compared to an age-, sex-, and UES-pressure-matched group of 23 patients (16 women/7 men; mean age: 44, range 22-75 years) without globus, nine (39%) had GER, thus showing no significant association of globus with GER (P = 0.35). There also was no significant association of GER with normal UES or with hypertensive UES in these patients. In conclusion, there is a significant association between hypertensive UES and globus. The data suggest two possible etiologies: female patients with normal UES pressure potentially having increased afferent sensation and a group with equal sex distribution but abnormally elevated UES resting pressure. This study does not support GER as an etiology of globus.