水灌注高分辨率食管测压正常值多中心研究  

The normal values of water-perfused high resolution esophageal manometry:a multicenter study

作　　者：段超凡 段志军[2] 马俊骥[3] 宁北芳 向雪莲[1] 肖英莲[5] 余跃 张建国[7] 张妮娜 张小昊[1] 陈畅[9] 刘杰[6] 李玲[9] 李亚旋 石亮亮[8] 田慧[3] 谭年娣 王东珂 杨冬[2] 袁宗丽 侯晓华[1] Duan Chaofan;Duan Zhijun;Ma Junji;Ning Beifang;Xiang Xuelian;Xiao Yinglian;Yu Yue;Zhang Jianguo;Zhang Nina;Zhang Xiaohao;Chen Chang;Liu Jie;Li Ling;Li Yaxuan;Shi Liangliang;Tian Hui;Tan Niandi;Wang Dongke;Yang Dong;Yuan Zongli;Hou Xiaohua(Department of Gastroenterology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430074,China;Department of Gastroenterology,the First Affiliated Hospital of Dalian Medical University,Dalian 116000,China;Department of Gastroenterology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Gastroenterology,the Second Affiliated Hospital,Naval Medical University,Shanghai 200003,China;Department of Gastroenterology,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;Department of Gastroenterology,the First Affiliated Hospital,University of Science and Technology of China,Hefei 230001,China;Department of Gastroenterology,Aviation General Hospital of China Medical University,Beijing 100012,China;Department of Gastroenterology,the Affiliated Hospital of Medical School of Nanjing University,Nanjing 210008,China;Department of Gastroenterology,the First People′s Hospital of Yichang,Yichang 443000,China)

机构地区：[1]华中科技大学同济医学院附属协和医院消化内科,武汉430074 [2]大连医科大学附属第一医院消化内科,大连116000 [3]河北医科大学第二医院消化内科,石家庄050000 [4]海军军医大学第二附属医院消化内科,上海200003 [5]中山大学附属第一医院消化内科,广州510080 [6]中国科学技术大学附属第一医院消化内科,合肥230001 [7]中国医科大学航空总医院消化内科,北京100012 [8]南京大学医学院附属鼓楼医院消化内科,南京210008 [9]宜昌市第一人民医院消化内科,宜昌443000

出　　处：《中华消化杂志》2022年第2期89-94,共6页Chinese Journal of Digestion

摘　　要：目的建立中国人群迈达水灌注高分辨率食管测压(HREM)系统(GAP-36A)静息期、水吞咽、黏胶吞咽和固体吞咽的正常值标准。方法2019年9月1日至2020年6月30日,在华中科技大学同济医学院附属协和医院、大连医科大学附属第一医院、河北医科大学第二医院、海军军医大学第二附属医院、中山大学附属第一医院、中国科学技术大学附属第一医院、中国医科大学航空总医院、南京大学医学院附属鼓楼医院、宜昌市第一人民医院9家医院招募91名健康志愿者,应用迈达水灌注HREM系统(GAP-36A)于静息期、水吞咽、黏胶吞咽和固体吞咽时进行食管测压。食管测压参数包括食管上括约肌(UES)和食管下括约肌(LES)上缘、下缘位置和长度,呼吸反转点(PIP)的位置,UES和LES静息压,以及吞咽相关参数如远端收缩积分(DCI)、4 s完整松弛压(IRP)、远端收缩延迟时间(DL)和UES残余压。统计学方法采用单因素方差分析、事后多重比较t检验和非参数秩和检验。结果最终纳入87名健康志愿者,男40名,女47名,年龄(范围)为(38.5±14.2)岁(19~65岁)。LES上缘、下缘位置分别为(42.7±2.8)、(45.6±2.8)cm,LES长度为(2.9±0.4)cm,PIP位置为(43.3±2.8)cm,UES上缘、下缘位置分别为(18.1±3.0)、(22.6±2.0)cm,UES长度为(4.8±1.0)cm。LES和UES静息压分别为(17.4±10.7)、(84.1±61.1)mmHg(1 mmHg=0.133 kPa)。固体吞咽的DCI高于水吞咽和黏胶吞咽[(2512.4±1448.0)mmHg·s·cm比(2183.2±1441.2)、(2150.8±1244.8)mmHg·s·cm],差异均有统计学意义(t=-4.30、-3.74,均P<0.001)。黏胶吞咽和固体吞咽的4 s IRP均低于水吞咽[(4.6±4.1)、(4.9±3.9)mmHg比(5.4±3.9)mmHg],差异均有统计学意义(t=3.38、2.09,P=0.001、0.037)。水吞咽的DL短于黏胶吞咽和固体吞咽[(8.5±1.8)s比(9.8±2.2)、(10.6±2.8)s],黏胶吞咽的DL短于固体吞咽,差异均有统计学意义(t=-10.21、-13.91、-4.68,均P<0.001)。水吞咽的UES残余压高于黏胶吞咽和固Objective To establish the normal values of water-perfused high resolution esophageal manometry(HREM)(GAP-36A)at resting period,water swallowing,semisolid swallowing and solid swallowing in Chinese population.Methods From September 1,2019 to June 30,2020,91 healthy volunteers receiving water-perfused HREM(GAP-36A)at resting period,water swallowing,semisolid swallowing and solid swallowing were selected from 9 hospitals(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology;the First Affiliated Hospital of Dalian Medical University;the Second Hospital of Hebei Medical University;the Second Affiliated Hospital,Naval Medical University;the First Affiliated Hospital,Sun Yat-sen University;the First Affiliated Hospital,University of Science and Technology of China;Aviation General Hospital of China Medical University;the Affiliated Hospital of Medical School of Nanjing University and the First People′s Hospital of Yichang).Parameters included the position of the upper and lower edges of the upper esophageal sphincter(UES)and lower esophageal sphincter(LES),the length of the LES and UES,the position of the pressure inversion point(PIP),the resting pressure of UES and LES and swallow-related parameters such as the distal contraction integral(DCI),4 s integrated relaxation pressure(IRP),distal latency(DL)and UES residual pressure.One-way analysis of variance,post-hoc test and sum rank test were used for statistical analysis.Results A total of 87 healthy volunteers were enrolled,including 40 males and 47 females,aged(38.5±14.2)years old(ranged from 19 to 65 years old).The position of the upper and lower edges of the LES was(42.7±2.8)and(45.6±2.8)cm,respectively,the length of the LES was(2.9±0.4)cm,and the position of PIP was(43.3±2.8)cm.The position of the upper and lower edges of the UES was(18.1±3.0)and(22.6±2.0)cm,respectively,and the length of the UES was(4.8±1.0)cm.The resting pressure of LES and UES was(17.4±10.7)and(84.1±61.1)mmHg(1 mmHg=0.133 kPa),respectively.The DCI value

关 键 词：高分辨率食管测压 水灌注 正常值 多中心研究 

分 类 号：R571[医药卫生—消化系统]