Objective To investigate the influence of the local sensory abnormality in throat while the change of motility in the upper esophageal sphincter(UES) and lower esophageal sphincter(LES),as well as the change of esophageal body in pharyngeal paraesthesia.Methods From January 2014 to January 2015 there were sixty-four patients who had pharyngeal susceptible syndrome(PSS) but without confirmed organic disease were enrolled as the PSS group,forty healthy volunteers as the control group.High resolution manometry(HRM) was utilized to distinguish esophageal motility patterns of PSS,including the muscular tension of LES and UES,the integrity,adaptability,amplitude,speed and duration of esophageal peristalsis at 10 swallows.Results The resting LES and UES pressures and the distal contractile integral(DCI) of esophagus in PSS group were lower than that in control group (P ＜ 0.05).The esophageal peristalsis was decelerated and shortened in duration,and amplitude of contraction notably lower in PSS group compared with its counterpart(P ＜0.05).The integrity of esophageal peristalsis was impaired in PSS with remarkable changes in motility patterns,involving ratio of major and minor interrupts,and synchronous contraction rate (P ＜ 0.05).As for the time course from relaxation to the lowest pressure point of UES and time for restoration,no definite difference was noticed between the two groups (P ＞ 0.05).The average peak pressure was similar in two groups (P ＞ 0.05).Conclusions Muscle tension around the UES has no obvious change when pharyngeal paraesthesia occured,but the reduction of esophageal motor function,elearance ability,anti-reflux gastroesophageal junction,causing the abnormal reflux which hurt the pharyngeal surface mucosa maybe one of the most important reasons leading to pharyngeal paresthesia.%目的 探讨食管上括约肌(upper esophageal sphincter,UES)、食管下括约肌(latter esophageal sphincter,LES)及食管体部动力变化对咽易感症患者咽喉部局部感觉异常的影响.方法 选择2014年1月至2015年1月有咽部易感症并排除器质性疾病的64例患者作为试验组,选择40名健康体检者作为对照组.采用高分辨食管胃肠测压系统监测两组受检者10次吞咽状态下UES和LES的肌张力、食管蠕动完整性、顺应性及蠕动收缩波幅、速度、持续时间的变化.结果 试验组患者的UES、LES静息压及食管远端收缩积分均低于对照组(P值均＜0.05);吞咽时食管蠕动波持续时间、蠕动波幅试验组低于对照组(P值均＜0.05);吞咽时食管蠕动波完整性百分比、大小型蠕动中断百分比、同步收缩百分比试验组与对照组比较,差异均有统计学意义(P值均＜ 0.05);UES松弛至压力最低点时间、恢复时间及压力峰值平均值试验组与对照组比较,差异无统计学意义(P＞0.05).结论 咽异感症患者的食管上括约肌周围咽部肌群张力无明显变化,而食管运动功能、廓清能力及胃食管结合部抗反流能力降低所导致的异常反流对咽肌表面黏膜的损害可能是导致咽异感症发生的重要原因之一.
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