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1、AmJPhysiolGastrointestLiverPhysiol288:G1000-G1006,2005;Bolustransitpatternsinhealthysubjects:astudyusingsimultaneousimpedancemonitoring,videoesophagram,andesophagealmanometryHalaImam,StevenShay,AmanAli,andMarkBakerDepartmentsofGastroenterologyandRadiology,Cle
2、velandClinicFoundation,Cleveland,OhioSubmitted15August2004;acceptedinfinalform21December2004ABSTRACT Impedancemonitoring(Imp)measuresbolustransit.CombiningImpwithmanometry(EM)allowstheeffectofcontractilepatternsontransittobeassessed.Theobjectiveofthisstudyist
3、oidentifybolustransitpatternsinnormalsubjects,correlateImpfindingswiththegoldstandardbariumesophagram(Ba),andcomparebolustransitwithconcomitantEMfindings.SimultaneousBa-Imp-EMwasperformedfor2minin15normalvolunteers(women,11;age,43yr).Combinedimpedance-pressur
4、esiteswere5,10,15,20cmabovetheloweresophagealsphincter(LES).Boluses(10ml)of45%bariummixedwith0.9%NaClwereswallowedat20-sintervals(5–6swallows/subject).ImpandBashowedthreebolustransitpatterns,andthetwomethodswereinagreementonthepatterntypein97%(83/86)ofswallow
5、s.Normalbolustransitwasfoundin73%(61/83),andeachhadnormalperistalsisandcontractionamplitude.Stasisintheproximalesophagusoccurredin7of83swallowsdespitenormalmanometricparametersin4of7swallows.Retrogradeescapeofaresidueofincompletelyclearedbolusfromjustabovethe
6、LEStothesite5cmaboveoccurredin14of83swallows.Retrogradeescapewastriggeredbythenextswallow,occurreddespitenormalmanometricparameters,anddidnotoccuriftheswallowintervalwas>30s.In55%(47/86)ofswallows,airaccumulatedinthedistalesophagusandpersistedthereforameanof3
7、.6suntilclearedintothestomach.Weconcludethatimpedancemonitoringisavalidtransittestanddescribebolustransitpatternsinnormalsubjectsforcomparisonwithpatientswithesophagealmotilitydisorders.esophagealmotilitydisordersPATIENTSWITHESOPHAGEALMOTILITYdisorderscommonl
8、yhavevideoesophagramandmanometryaspartoftheirdiagnosticevaluation.Videoesophagramisthegoldstandardforexaminingesophagealbolustransit,whereasmanometryisthegoldstandardforesophagealmotility
