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在高分辨率测量仪上的缺席收缩现象中识别阿哈拉西亚:患病率,预测因素和治疗结果
Parth Patel1, Benjamin D Rogers1,2, Arvind Rengarajan1
1Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.
The American journal of gastroenterology
|February 1, 2024
概括
高分辨率测量仪 (HRM) 显示不存在收缩性,可能表明阿哈拉西亚. 这项研究发现,超过10%的缺乏收缩能力的患者患有秋拉西亚,这凸显了进一步诊断测试的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 食道运动障碍 食道运动障碍
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在高分辨率测量仪 (HRM) 上缺少收缩性是严重食道低流动性的标志.
- 从临床上来说,区分阿喀拉西亚与其他缺乏收缩性的原因是有意义的.
- 挑性的机动,食管学和功能性光成像探针 (FLIP) 可以帮助诊断.
研究的目的:
- 在HRM上缺少收缩性的患者中识别阿卡拉西亚.
- 评估辅助诊断工具在这个患者群体中的有用性.
- 为了比较阿喀拉西亚的临床和测量特征与没有阻塞的缺席收缩性.
主要方法:
- 在HRM上缺乏收缩性的成年患者的回顾性分析.
- 纳入标准:没有HRM的收缩性;排除:之前的治疗,手术.
- 秋拉症的诊断标准包括在挑性测试中出现异常的综合放松压力 (IRP),食道保持或在FLIP上出现异常的食道胃结 (EGJ) 伸缩性.
主要成果:
- 在164名患者中有20名 (12.2%) 和接受辅助测试的患者中有17.9%的阿哈拉西亚被确定.
- 阿哈拉西亚诊断独立于综合放松压力 (IRP) 值.
- 患有阿喀拉西亚的患者更有可能出现食障碍和阻塞性HRM特征,并且不太可能患有GERD或大间隙.
结论:
- 在HRM上缺少收缩能力的患者中,超过10%的患者发现了阿哈拉西亚.
- 即使没有收缩性,也应该考虑对阿喀拉西亚进行诊断评估,无论IRP如何.
- 缺食症和特定的HRM发现预测了这个队列中的achalasia.
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