Parkinson's disease (PD) is associated with a high incidence of dysphagia. Aspiration pneumonia due to dysphagia is a major cause of death in patients with PD, and therefore accurately evaluating dysphagia should help improve prognosis. It has been reported that the severity of dysphagia does not always correlate with the Hoehn and Yahr (H&Y) stage for classifying PD severity. However, no reports have quantitatively evaluated the relationship between severity of dysphagia and H&Y stage. High-resolution pharyngeal manometry (HRPM) is a quantitative method that can be used to measure swallowing pressure from the velopharynx to the entry of the upper esophageal sphincter (UES). We used HRPM to measure swallowing pressure in 51 patients with PD. As PD progresses, atrophy and degeneration of the pharyngeal muscles become more pronounced, which contributes to dysphagia. However, thus far there is no quantitative clinical evidence for this pathological change. To evaluate the relationship between severity of underlying PD and dysphagia, patients were categorized by H&Y stage, as follows: stage II in four patients, stage III in 23, stage IV in 14, and stage V in 10. In patients with H&Y stages II, III, IV, and V, the respective velopharyngeal pressures were 179.8 ± 32.5, 157.6 ± 62.2, 172.2 ± 48.9, and 107.4 ± 44.0 mmHg, the mesopharyngeal pressures were 126.8 ± 53.2, 121.6.1 ± 50.4, 142.1 ± 57.8, and 61.4 ± 19.6 mmHg, the residual UES pressure were -8.0 ± 10.8, 10.3 ± 16.1, 16.5 ± 37.9, and 11.2 ± 16.2 mmHg, and the resting UES pressure were 49.5 ± 30.0, 15.8 ± 25.7, 1.85 ± 14.1, and -1.2 ± 12.2 mmHg. Patients with severe PD demonstrated significantly decreased velopharyngeal and oropharyngeal pressures, along with incomplete UES opening and contraction. HRPM can detect subtle abnormalities by quantifying swallowing pressure in patients with PD. Evaluating swallowing pressure with HRPM provides insights into neuromuscular dysfunction that causes abnormal pressure generation during pharyngeal swallowing in patients with PD.

中文翻译：

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使用高分辨率咽部测压法评估咽部和上食管括约肌的运动能力，治疗帕金森病

帕金森病 (PD) 与吞咽困难的高发病率有关。吞咽困难引起的吸入性肺炎是 PD 患者死亡的主要原因，因此准确评估吞咽困难有助于改善预后。据报道，吞咽困难的严重程度并不总是与用于分类 PD 严重程度的 Hoehn 和 Yahr (H&Y) 阶段相关。然而，没有报道定量评估吞咽困难的严重程度与 H&Y 分期之间的关系。高分辨率咽测压 (HRPM) 是一种定量方法，可用于测量从腭咽到上食管括约肌 (UES) 入口的吞咽压力。我们使用 HRPM 测量了 51 名 PD 患者的吞咽压力。随着PD的进展，咽部肌肉的萎缩和退化变得更加明显，这会导致吞咽困难。然而，到目前为止，还没有关于这种病理变化的定量临床证据。为了评估潜在 PD 的严重程度与吞咽困难之间的关系，患者按 H&Y 分期进行分类，如下所示：4 名患者为 II 期，23 名患者为 III 期，14 名患者为 IV 期，10 名患者为 V 期。 ，III，IV和V中，各腭咽压力是179.8±32.5，157.6±62.2，172.2±48.9和107.4±44.0毫米汞柱，所述mesopharyngeal压力是126.8±53.2，121.6.1±50.4 142.1±57.8，和61.4±19.6 mmHg，残余UES压力分别为-8.0±10.8、10.3±16.1、16.5±37.9和11.2±16.2 mmHg，静息UES压力分别为49.5±30.0、15.5、1±1.2±1.2和15.8±16.2 ± 12.2 毫米汞柱。严重 PD 患者的腭咽和口咽压力显着降低，同时 UES 打开和收缩不完全。HRPM 可以通过量化 PD 患者的吞咽压力来检测细微的异常。使用 HRPM 评估吞咽压力可以深入了解导致 PD 患者咽部吞咽过程中产生异常压力的神经肌肉功能障碍。