Study On The Correlation Between Esophageal Pressure Changes And Mental State In Patients With Globus Hystericus

Objective To study the correlation between esophageal pressure and mental state in patients with globus hystericus,and to explore the correlation between symptoms of globus hystericus and esophageal pressure and mental state,and to further explore the causes and influencing factors of globus hystericus,so as to provide theoretical basis for the etiological treatment of globus hystericus.Methods From October 2017 to December 2018,60 patients with hysteria were enrolled in the Department of Gastroenterology,Baotou Central Hospital,Inner Mongolia,including 30 males and 30 females,with an average age of 44.88 + 8.12 years.High Resolution Manometry(HRM)was used to detect the resting pressure of Upper Esophageal Sphincter(UES),residual pressure of UES,resting pressure of Lower Esophageal Sphincter(LES)and Integrated Relaxation Pressure(IRP)in patients with globus hystericus.According to the upper limit of normal resting pressure of UES(180 mmHg,1 mmHg = 0.133 kPa),the patients were divided into two groups: high pressure group(n = 16)and non-high pressure group(n = 44).All patients were assessed with Glasgow-Edinburgh Throat Scale(GETS),Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Results 26.7%(16/60)of the 60 patients with hysteria showed elevated UES resting pressure,48.33%(29/60)showed elevated UES residual pressure.There were significant differences in duration of disease,GETS score,UES resting pressure and HAMA score between the hypertensive group and the non-hypertensive group(P < 0.05).GETS score was positively correlated with duration of disease,UES resting pressure,UES residual pressure and HAMA score(P < 0.05),but not with LES resting pressure,IRP and HAMD score(P > 0.05).Multiple linear regression analysis showed that UES resting pressure,UES residual pressure and HAMA score were the influencing factors of the severity of hysteria.The final equation to fit the influencing factors of hysteria symptoms was: the severity of hysteria symptoms(GETS score)= 1.924+0.22(UES resting pressure)+0.42(UES residual pressure)+0.84(HAMA score).Bivariate logistic regression analysis showed that there was a certain correlation between esophageal pressure changes and anxiety state in patients with hysteria.The final equation to fit the influencing factors of esophageal pressure changes in patients with hysteria was: the degree of esophageal pressure changes in patients with hysteria = 8.108 + 0.468(HAMA score).Conclusion(1)The pressure of upper esophageal sphincter is increased in hysteria patients.(2)GETS score of hysteria patients was positively correlated with duration of disease,UES resting pressure and UES residual pressure,but not with LES resting pressure and IRP.(3)GETS score of hysteria patients was positively correlated with anxiety,but not with depression.(4)Comparing the patients with hysteria in the high-pressure group and the non-high-pressure group,we found that the pharyngeal symptoms in the high-pressure group were more obvious,the course of the disease was longer,the incidence of anxiety was higher,and the state of anxiety was more significant,which indicated that the change of UES resting pressure in the patients with hysteria was positively correlated with the state of anxiety.