肺移植接受者的食道收缩和屏障功能的变化
Phoebe Chun1, Megan Chan2, David Nunley3
1Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
概括
肺移植接受者在手术后表现出改善的食道收缩性和减少的胃食道逆流. 还观察到食道屏障功能的变化,这可能对全移植功能的影响.
科学领域:
- 胃肠病学 胃肠病学
- 肺部病理学 肺部病理学
- 移植手术 移植手术
背景情况:
- 胃食道逆流是慢性肺异位移植功能障碍的已知危险因素.
- 消化管不运动越来越多地在肺移植接受者中得到认可.
- 输卵管收缩性,屏障功能和移植后逆流之间的相互作用尚未得到充分理解.
研究的目的:
- 为了评估肺移植后食道功能的变化.
- 评估食道收缩性,屏障功能和移植前和移植后的逆流事件.
- 为了确定影响食道收缩性和酸暴露的因素.
主要方法:
- 对36名肺移植接受者进行了回顾性审查,这些接受者接受了移植前和移植后的食道计量和pH阻抗研究.
- 对29名患者的分析,不包括在测试后30天内使用麻醉剂.
- 所有食道研究的盲目随机阅读;使用非参数测试进行比较.
主要成果:
- 移植后胃食道逆流改善,通过减少远端酸暴露时间 (AET) 表示.
- 肺移植后食道收缩率显著增加 (p=0.01).
- 显著降低跨隔膜压力梯度和食道上关节压力;远距离收缩积分和AET之间的反向相关性 (p=0.041).
结论:
- 肺移植与食道收缩率的增加和食道屏障功能在食道胃结处的改善有关.
- 移植后观察到上食道屏障功能的显著下降.
- 收缩性和酸暴露之间的反向关系可能会影响GERD的结果,因此需要进一步调查全移植功能.
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