食管高级别上皮内瘤变患者高分辨率食管测压特点分析OA

Objective To investigate the characteristics of high-resolution esophageal manometry(HREM)in patients with high-grade intraepithelial neoplasia(HGIN)of the esophagus.Methods Thirty patients with pathologically confirmed HGIN were selected as the case group,and 20 healthy volunteers were chosen as the control group.Both groups underwent HREM to com-pare the resting upper esophageal sphincter pressure(UESP),upper esophageal sphincter relaxation rate(UESRR),resting lower esophageal sphincter pressure(LESP),integrated relaxation pressure(IRP),and distal contractile integral(DCI).Results In the case group,total 300 attempts of swallowing 5 mL of water were completed.Among these,there were 87 instances of normal con-traction(29.00％),115 instances of weak peristalsis(38.33％),and 98 instances of peristalsis failure(32.67％).The control group completed a total of 200 single-mouthful swallows,including 166 instances of normal contraction(83.00％),31 instances of weak peristalsis(15.50％),and 3 instances of peristalsis failure(1.50％).There were significant differences in the types of e-sophageal peristalsis between two groups(x2=148.285,P＜0.001).The distal contractile integral(DCI)of case group was 220.00(116.00,507.25)mmHg,which was significantly lower than that of control group[686.50(508.50,871.00)mmHg](Z=-3.812,P＜0.05).The upper esophageal sphincter pressure(UESP)of case group was 37.00(21.50,50.50)mmHg,significantly lower than that of control group[52.00(43.25,59.75)mmHg](Z=-2.487,P＜0.05).However,there was no significant difference in the upper esophageal sphincter relaxation rate(UESRR)[55.50％(35.00％,73.25％)vs.64.50％(58.75％,73.50％)](Z=-1.735,P＞0.05).The lower esophageal sphincter pressure(LESP)and integrated relaxation pres-sure(IRP)in the case group were 18.50(16.00,24.00)mmHg and(3.51±2.39)mmHg respectively,which were lower than those in the control group[22.00(16.75,27.75)mmHg and(4.46±2.19)mmHg respectively],but the differences were not statistically significant(Z=-1.428,t=-1.423,P＞0.05).Conclusion Patients with esophageal HGIN have the characteris-tics of weakened esophageal peristalsis and decreased UESP.Esophageal motility disorder may be closely related to the occurrence and development of HGIN.