| Objectives：High resolution esophageal manometry（HRM）is further studied in the clinicaland scientific research in our country, and then it turns into the high resolutionesophageal impedance manometry（HRIM）. But it is still lack of normative valuesof the high resolution esophageal impedance manometry in China. The aim of thisstudy devoted to set up the normative values of the high resolution esophagealimpedance manometry and provided a basis for the esophageal motility disorders andto determine if body position or different bolus swallow modifies oesophagealmorphology and motility.Methods：1.110asymptomatic volunteers were studied by HRIM.Studies were analyzedof esophageal manometry resting and liquid swallow, setted up normative values ofthe high resolution esophageal impedance manometry. At the same time studied thedifferent between the gender and the age effect on esophageal motility.2. A total of98asymptomatic volunteers were included in this study. Theoesophageal HRIM protocol included examination in supine and sitting positions.Recordings were reviewed by two different operators.3. A total of27asymptomatic volunteers were included in this study.Studieswere analyzed for esophageal manometry in supine position with different bolusswallow.Results:1.(1) Double swallowing or several swallowing or invalid swallowing wereexcluded and finally1050liquid material swallows were analyzed. All parameterswere expressed as [mean±SD,P95].The position of the anatomy structures were thedepth of nostrils.(2)The position of the UES midpoint,margo superior, inferior margin were [18.32±1.42,21.00]cm,[16.45±1.46,19.17]cm，[20.52±1.51,23.10]cm.The position of the LES midpoint,margo superior, inferior margin were [42.96±3.17,48.37]cm,[41.20±3.28,46.96]cm,[45.13±3.21,50.40]cm.The pressure inversionpoint were [42.44±3.20,47.57]cm.The length of UES,LES,the esophagus andintraabdominal LES were [4.084±0.70,5.27]cm,[3.92±1.91,5.10]cm,[24.99±1.91,29.07] cm,[2.69±0.62,3.80]cm.(3)The UES resting pressure was[77.29±30.28,118.60]mmHg, The LES respiratory minimal pressure was [16.60±8.24,35.83]mmHgand the LES respiratory average pressure was [22.70±8.30,40.81]mmHg.(4)Theresidual pressure of UES was [7.07±8.50,22.96]mmHg.The recovery time of UESwas [474.26±154.16，682.90]ms.The4s IRP was [12.35±5.15,22.17]mmHg and theIBP was [10.92±9.14,26.54]mmHg.(5)The average value of DCI was [1601.99±882.96,3135.31]mmHg/cm/s,the maximum value of DCI was[2184.53±1113.29,4395.41]mmHg/cm/s,the CFV was [4.31±0.87,6.10]cm/s,the DL was [6.21±0.79,7.57]s.(6)Normal liquid swallowing of asymptomatic volunteers had incomplete bolustransit by impedance,the BTT was[6.91±1.06,8.40]s.（7）Females’resting pressureof LES is significantly higher than males, the relaxation of UES and LES showed nostatistical diffence, males’velocity of LES on11-7cm is faster than female, women’sthe wave amp of LES on3cm is more than men.The incomplete bolus transit byimpedance and the BTT have no statistical significance.（8）Age had no effect onHRIM.2.(1)Body position modifies oesophageal morphology;(2)The loweroesophageal sphincter resting pressure was significantly changed by the supine andsitting positions[16.81±8.42134,36.77vs8.89±5.65708,9.41, P＜0.01];(3) Thepercentage of peristaltic wave time was significantly lower in the sitting position incomparison with the supine position. The DCI was also significantly lower in thesitting position as well as the amplitude of oesophageal waves.(4)The complete bolustransit by the supine positions by impedance was significantly more complete by bodyposition.3.（1）The velocity of oesophageal with liquid swallow were faster than viscousswallow,and also and the wave duration of the upper and middle segmentesophagus.（2）The DCI of viscous swallow was significantly higher than liquid swallow[the average value of DCI675.73±535.21,2066.58mmHg vs1023.30±667.57,2823.80,P＜0.05], the IBP was also significantly higher [7.82±2.42,11.34mmHgvs5.54±2.66,9.58, P＜0.01].On the contrary,the CFV of viscous swallow wassignificantly lower than liquid swallow [3.16±0.40，3.90vs4.13±0.89,6.10cm/s,P＜0.01].（3）The incomplete bolus transit by impedance was not significantly changedby different bolus swallow.Conclusions:1.Our research get the normative values of the high resolution esophagealimpedance manometry in our country.2.Change body positions and different bolus swallpw can modify the referencevalues of the high resolution impedance esophageal manometry.3. This study may provides a strong reference for application of HRIM inevaluation of esophageal motility and drug efficacy of patients in the future. |
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