Analysis Of Esophageal Motility Characteristics In Achalasia Of Cardia

Objective: To investigate the esophageal motility characteristics in patients with achalasia of cardia(AC) and evaluate the clinical significance of high resolution manometry(HRM).Methods: Fifty four patients from January 2012 to January 2016 at the affiliated Hospital of Zunyi Medical university who were first-diagnosed achalasia of cardia were enrolled for HRM examination,and typing based on Chicago classification criteria.Comprehensive clinical data were summaried restrospectively in 54 cases of patients with achalasia of cardia,we uesed statistical methods to analysis the main parameters of high resolution manometry,which included lower esophageal sphincter resting pressure(LESP),integrated relaxation pressure(IRP),lower esophageal sphincter length(LESL),distal contractile integral(DCI),upper esophageal sphincter resting pressure(UESP),and upper esophageal sphincter residual pressure(UESRP).The above indicators were compared in different subtypes of achalasia of cardia, then obtained the conclusion.Results: Of the 54 achalasia of cardia patients,40 cases(74.07%) were Type II,9 cases(16.67%) were Type I,and 5 cases(9.26%) were Type III.Both male and female account for 50%.Comprehensively analysised the diseased age, height and HRM main parameters(LESL,IRP,LESP,DCI,UESP,USERP) of the 54 patients.Statistical analysis:1)at height and diseased age aspects:the average diseased age in type I was lower than that of type II(P<0.05), the average height in type I was higher than that of type II(P<0.05).2)the main parameters of high resolution manometry:there was no significance difference among the three subtypes in LESL,IRP,LESP,UESP(P>0.05),the IRP was stongly correlated with the LESP(P<0.01,r=0.705), the DCI in type III was higher than that of type I(P<0.05),and the UESRP in type III was lower than that of type II(P<0.05).3)At different height intervals:no significant difference was found(P>0.05) in LESL and IRP self-comparison.Conclusion: 1)in patients with achalasia of cardia,type II is more common and type III is more rare;2)HRM examination is the main basis for achalasia of cardia diagnosis and classification.IRP can reflect the LES flaccid function.DCI plays an important role in classification and prediction of clinical symptoms.Achalasia of cardia,especially type II,might influence the function of UES.But all of these results still need to be confirmed by further large sample data.