Analysis Of Clinical Features And Esophageal Motility In Patients With Distal Esophageal Spasm (DES)

Objective: Aiming at improving the diagnosis and understanding of esophageal motility disorders,the paper analyzed the clinical features and parameters of esophageal motility examination in patients with distal esophageal spasm(DES).Methods: The medical records of patients treated in our hospital from January 2015 to December 2020 who had completed solid-state high-resolution esophageal manometry were collected and divided into the distal esophageal spasm group(DES group)and control group(excluding esophageal motility disorders and reflux esophagitis).The paper analyzed the differences of parameters including general information,solid-state high-resolution esophageal manometry,and 24-hour p H and p H-impedance monitoring parameters of two groups.Binary Logistic regression analysis was used to explore independent risk factors of DES.Results:1.The detection rate of DES was 4.21%(64/1520),and the main clinical manifestations were chest pain,dysphagia or sense of obstruction.110 research subjects were included.64 subjects in the DES group and 46 subjects in the control group.The average age of the DES group(47.2 ± 10.83)was larger than that of the control group(38.74 ± 11.92)(P<0.001),and there were no differences in gender,body mass index,smoking and drinking history,and gastroscopic examination reports between the two groups(all P>0.05)..Symptom analysis showed that chest pain was more common in the DES group(P<0.001),and acid reflux was more common in the control group(P=0.004).2.HRM parameter analysis and comparison results showed that the LES resting pressure in the DES group(17.71±7.25)was lower than that in the control group(22.25±6.79)(P=0.001),and the IBP in the DES group when the LES was relaxed(3.67±2.35)was lower than that in the control group(4.93±2.44)(P=0.007),there was no difference between the two groups in LES length,LES residual pressure and relaxation rate,UES resting pressure and residual pressure,average DCI,highest DCI,and average IBP(P>0.05);Comparing the control group,esophagogastric junction outflow obstruction(EGJOO)was more common in the DES group(P=0.04).With the comparison and analysis of data from the two groups,which the parameters of rapid swallowing showed that small defects(P=0.004)and no peristalsis(P=0.03)were more common in the DES group.There was no difference between the two groups 24-hour p H and p H-impedance monitoring parameters(P>0.05).3.After binary Logistic univariate regression analysis,variables that may be associated with the diagnosis of DES were screened out: age(P=0.001),chest pain(P=0.001),LES resting pressure(P=0.002),LES relaxation rate(P=0.013)and IBP at the time of LES relaxation(P=0.007);With the introduction of binary Logistic multivariate regression analysis method,the general clinical data analysis showed that the probability of developing DES increased by 1.084 times for each 1-year increase in age(OR 1.084,95%CI 1.034-1.137,P=0.001).Conclusion:1.The detection rate of DES was 4.21%(64/1520),the age of onset was 50-60 years old,and the main clinical manifestations were chest pain,dysphagia or sense of obstruction.HRM was the main method for diagnosing DES.For patients with the above symptoms After excluding cardiopulmonary diseases and tumors,the possibility of DES in esophageal motility disorders should be considered,and esophageal motility examinations should be further improved.2.The comparative analysis of HRM-related parameters between the DES group and the control group showed that the LES resting pressure in the DES group was lower than that in the control group,DES could be combined with EGJOO,and multiple rapid swallowing analysis Showed there were more small defects and no-peristalsis symptoms in DES group.There are many DES groups.There were no difference in the 24-hour p H and p H-impedance monitoring indexes between the DES group and the control group.3.Age was independent risk factors of DES.