背景:胃肠道系统中与年龄相关的变化是常见的,并且可能受到生理衰老过程的影响。迄今为止,不同年龄组患者食管运动障碍的综合分析尚未得到充分报道.
方法:我们在多中心环境中对高分辨率测压(HRM)研究进行了回顾性评估。根据芝加哥分类4.0版评估人力资源管理参数。流行病学,人口统计学,临床资料,和主要测压参数,是在检查时收集的。年龄组被归类为成年早期(<35岁),中年早期(35-49岁),中年晚期(50-64岁),和成年后期(≥65岁)。
结果:总体而言,纳入1341例患者(632例,男性占47.0%),中位年龄为55岁。成年晚期患者报告吞咽困难(35.2%)比成年早期患者(24.0%,p=0.035),中年早期患者(21.0%,p<0.0001),和晚期中年患者(22.7%,p<0.0001)。食管胃交界处流出道梗阻在成年后期(16.7%)比成年早期(6.1%,p=0.003),在中年早期(8.1%,p=0.001)。食管运动正常的患者(52.0岁)明显年轻于食管过度收缩的患者(61.5岁),III型贲门失弛缓症(59.6年),食管胃结合部流出道梗阻(59.4年),缺乏收缩力(57.2年),远端食管痉挛(57.0年),在多变量模型中(p<0.0001)。
结论:老年患者食管运动障碍的发生率更高,特别是食管胃交界处流出梗阻和食管过度收缩。未来的前瞻性研究是必要的,以证实我们的结果,并找到量身定制的策略,以改善临床结果。
BACKGROUND: Age-related changes in the gastrointestinal system are common and may be influenced by physiological aging processes. To date, a comprehensive analysis of esophageal motor disorders in patients belonging to various age groups has not been adequately reported.
METHODS: We conducted a retrospective assessment of high-resolution manometry (HRM) studies in a multicenter setting. HRM parameters were evaluated according to the Chicago Classification version 4.0. Epidemiological, demographic, clinical data, and main manometric parameters, were collected at the time of the examination. Age groups were categorized as early adulthood (<35 years), early middle-age (35-49 years), late middle-age (50-64 years), and late adulthood (≥65 years).
RESULTS: Overall, 1341 patients (632, 47.0% male) were included with a median age of 55 years. Late adulthood patients reported more frequently dysphagia (35.2%) than early adulthood patients (24.0%, p = 0.035), early middle-age patients (21.0%, p < 0.0001), and late middle-aged patients (22.7%, p < 0.0001). Esophagogastric junction outflow obstruction was more prevalent in late adulthood (16.7%) than in early adulthood (6.1%, p = 0.003), and in early middle-age (8.1%, p = 0.001). Patients with normal esophageal motility were significantly younger (52.0 years) than patients with hypercontractile esophagus (61.5 years), type III achalasia (59.6 years), esophagogastric junction outflow obstruction (59.4 years), absent contractility (57.2 years), and distal esophageal spasm (57.0 years), in multivariate model (p < 0.0001).
CONCLUSIONS: The rate of esophageal motor disorders is higher in older patients, in particular esophagogastric junction outflow obstruction and hypercontractile esophagus. Future prospective studies are necessary to confirm our results and to find tailored strategies to improve clinical outcomes.