Assessment of oesophageal motor function using combined perfusion manometry and multi-channel intraluminal impedance measurement in normal subjects
Assessment of oesophageal motor function using combined perfusion manometry and multi-channel intraluminal impedance measurement in normal subjects
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DOI：
10.1111/j.1365-2982.2005.00646.x
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发表时间：
2005-06-01
影响因子：
3.5
通讯作者：
Holloway, RH
中科院分区：
文献类型：
--
作者：
Nguyen, NQ;Rigda, R;Holloway, RH
多通道腔内阻抗(MII)越来越多地被用于评估食管团的清除。然而，没有良好的标准化的阻抗参数来定义‘有效的团注清除’。为了明确这些重要的阻抗参数并确定它们的正常值，我们对42名健康志愿者同时进行了血流灌注测压和MII检查。每名受试者右位分别测试10个5毫升液体(生理盐水)丸剂和10个5毫升低阻抗粘性丸剂。根据“正常”的蠕动反应(食道远端的振幅=30 mm Hg)或“超常”的蠕动反应(所有部位的振幅均为50 mm Hg)来确定每个部位的团注存在时间(BPT)和团团总传递时间(TBTT)的正常值。确定了回答中的bpt和tbtt与个人表现之间的关系。总共分析了840个吞咽的液体和粘性反应。粘性燕子的bpt和tbtt均长于液体燕子。与液体丸剂相比，非蠕动反应更有可能不清除粘性物质。在一个反应中，BPT延长的部位数量强烈地预测了tbtt延长的发生率。使用阻抗标准，当个体完全清除至少70%的液体反应和至少60%的粘性反应时，就定义了正常的食管丸清除。本研究提供了与血流灌注测压相结合的团注清除阻抗测量的正常值。这些值将使阻抗在食道功能测试中的应用标准化，在研究和临床设置中都是如此。
Multichannel intraluminal impedance (MII) is being used increasingly to assess oesophageal bolus clearance. However, there is no good standardization of the impedance parameters that define 'effective bolus clearance'. The aim of this study was to define these important impedance parameters and to determine their normal values, Concurrent perfusion manometry and MII were performed in 42 healthy volunteers. Ten, 5-mL liquid (saline) boluses and then, 10 x 5-mL low impedance viscous boluses were tested in each subject in the right-lateral position. Normal values for bolus presence time (BPT) at each site and total bolus transit time (TBTT) were determined from either 'normal' peristaltic responses (amplitude >= 30 mmHg in distal oesophagus) or 'super-normal' peristaltic responses (amplitudes >= 50 mmHg at all sites). The relationship between BPT and TBTT within a response and per-individual performance was determined. A total of 840 swallows of liquids and viscous responses were analysed. BPT and TBTT of viscous swallows were longer than those for liquids. Non-peristaltic responses were significantly more likely not to clear a viscous than a liquid bolus. Within a response, the number of sites with prolonged BPT strongly predicted the incidence of prolonged TBTT. Using impedance criteria, normal oesophageal bolus clearance is defined when an individual completely clears at least 70% of liquid responses and at least 60% of viscous responses. This study provides normal values for impedance measurement of bolus clearance when combined with perfusion manometry. These values will allow standardization of impedance application in oesophageal function testing, in both research and clinical setting.