High resolution manometry analysis of esophageal motility in type Ⅱ achalasia patients / 中华消化内镜杂志

ABSTRACT

Objective To investigate the characteristics of esophageal motility in patients with type Ⅱ achalasia and evaluate the clinical value of high resolution manometry (HRM).Methods A total of 20 patients with type Ⅱ achalasia(observation group) and 15 healthy controls(control group) were enrolled for high resolution manometry.The characteristics of esophageal motility of two groups were compared.Results The motor pattern of esophageal body of observation group was mostly non-conductive synchronous contraction(88.2％,176/200),but in control group it was normal esophageal peristalsis.Lower esophageal sphincter pressure,4 s integrated relaxation pressure(4s IRP) and upper esophageal sphincter residual pressure in observation group were (37.6 ± 12.8)mmHg,(31.5 ± 13.4)mmHg and (14.0 ± 3.8)mmHg,respectively,which were higher than those ot the control group,(23.7 ± 5.6) mmHg(t =3.925,P =0.000),(10.5 ±4.3) mmHg(t =5.835,P =0.000) and (7.9 ± 4.5) mmHg (t =4.325,P =0.000).The lower esophageal sphincter relaxation rate in observation group was(23.6 ± 19.6)％,which was lower than that of the control group(58.1 ±16.7)％ (t =-5.491,P =0.000).There was no significant difference in lower esophageal sphincter length and upper esophageal sphincter pressure between type Ⅱ achalasia group and control group (P ＞0.05).Conclusion The characteristics of esophageal manometry in type Ⅱ achalasia is non-conductive synchronous contraction and elevated 4s IRP,and HRM contributes to early diagnosis,reclassification and evaluation of expected outcome in achalasia.