咽部异感症患者食管高分辨率测压的特点及机制研究  

Study on the Characteristic and Mechanism of HRM in Patients with Pharyngeal Paraesthesia

作　　者：周利萍 张昱 彭丽清 李欢 李岩 ZHOU Li-ping;ZHANG Yu;PENG Li-qing;LI Huan;LI Yan(Medical School of Kunming University of Science and Technology,Kunming 650500,Yunnan Province,China;Department of Gastroenterology,the Affiliated Hospital of Kunming University of Science and Technology,the First People′s Hospital of Yunnan Province,Kunming 650032,China)

机构地区：[1]昆明理工大学医学院,650500 [2]昆明理工大学附属医院云南省第一人民医院消化内科,650032

出　　处：《现代消化及介入诊疗》2021年第12期1531-1534,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：云南省科技厅科技计划项目(202001AY070001-297);云南省临床医学中心开放项目(2019LCZXKF-XH07)。

摘　　要：目的探讨咽部异感症患者的食管高分辨率测压(HRM)的结果特点,比较分析其上食管括约肌(UES)、下食管括约肌(LES)及食管体部运动的特点,并进一步探讨咽部异感症的发病机制。方法回顾性选取2013年8月至2020年5月在云南省第一人民医院消化内科均进行了HRM的109例咽部异物感患者纳入观察组,纳入78名健康志愿者行HRM检查作为对照组。结果与对照组相比,观察组的UES平均静息压(UESP)及残余压(UESRP)均高于对照组(P<0.05),观察组的食管下括约肌残余压(IRP)小于对照组(P<0.05);两组间的LES静息压(LESP)、远端收缩积分(DCI)无组间差异(P>0.05)。结论咽异感症患者具有明显的UES高压、IRP低压的特点,环咽肌的痉挛及LES过度松弛导致的胃食管反流可能是咽部异感症的发生机制,而与食管体部的运动障碍无关。Objective To investigate the characteristics of the results of high-resolution manometry(HRM)in patients with pharyngeal paraesthesia,and to compare and analyze the features of the upper esophageal sphincter(UES),lower esophageal sphincter(LES)and esophageal body movement to further explore the pathogenesis of pharyngeal paraesthesia.Method 109 patients with pharyngeal paraesthesia who underwent HRM in the Gastroenterology Department of the First People′s Hospital of Yunnan Province from August 2013 to May 2020 were included in the observation group.78 healthy volunteers were included in the control group.ResultCompared with the control group,the UES basal pressure(UESP)and residual pressure(UESRP)of the observation group were higher than those of the control group(P<0.05).The observation group′s integrated relaxation pressure(IRP)was smaller than those of the control group(P<0.05);There was no difference between the two groups in LES basal pressure(LESP)and distal contractile integral(DCI)(P>0.05).Conclusion Pharyngeal paraesthesia have characteristics of UES hypertension and low IRP,and its mechanism may be related to cricopharyngeal muscle spasm and gastroesophageal reflux caused by excessive relaxation of the LES,but has nothing to do with esophageal body movement disorders.

关 键 词：食管高分辨率测压 咽部异感症 上食管括约肌 下食管括约肌 食管动力障碍 

分 类 号：R766.5[医药卫生—耳鼻咽喉科] R571[医药卫生—临床医学]