[Manometric evaluation of esophageal motor activity during diabetes mellitus].

P Usai, S Gemini, M V Cherchi, M F Boy, A Balestrieri, F Sirigu
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Abstract

Intraluminal manometry was used to assess the motor activity of the oesophagus and upper (UES) and low (LES) oesophageal sphincter in 10 patients, 5 female and 5 male, average age 35.9 range 17-50, suffering from insulin-dependent diabetes mellitus. Non-invasive cardiovascular tests were also performed to evaluate autonomous neuropathy together with control tests of glyco-metabolic compensation (fructosamine and HbA1c). An increase in the basic tone of the UES was observed in 8 patients while in 3 this was associated with its incomplete release. Five patients evidenced aspecific motor disturbance such as spontaneous motor activity characterised by repetitive segmentary waves at times with biphasic appearance. IOS activity was within normal limits. It is considered that these disturbances may be attributable to the autonomous neuropathy that often complicates diabetes mellitus and that oesophageal motor disturbance, albeit aspecific, should be considered an early sign of autonomous neuropathy. It is therefore though that manometric oesophageal study may be considered a useful investigative tool for early evidencing of disturbances linked to autonomous neuropathy.

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[糖尿病患者食管运动活动的压力测量评价]。
采用腔内测压法对10例胰岛素依赖型糖尿病患者(男5女5,平均年龄35.9,范围17 ~ 50岁)食道及食道上括约肌(UES)和食道下括约肌(LES)的运动活动进行评估。同时进行无创心血管试验来评估自主神经病变,同时进行糖代谢代偿(果糖胺和糖化血红蛋白)对照试验。8例患者观察到UES的基本张力增加,而3例患者观察到UES的不完全释放。5例患者表现出特定的运动障碍,如自发性运动活动,其特征是重复的节段波,有时具有双相外观。IOS活动在正常范围内。我们认为,这些障碍可能是由自主神经病变引起的,而自主神经病变常并发糖尿病,而食管运动障碍虽然是特异性的,但应被视为自主神经病变的早期征兆。因此,尽管食管测压研究可能被认为是一种有用的调查工具,可以早期证明与自主神经病变相关的紊乱。
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