Impairment of swallowing is a common symptom in advanced stage of Parkinson's disease and severe defect of this function may cause aspiration pneumonia, problems with food intake and cachexy. The aim of this study was to assess the reflex and oral, pharyngeal, oesophageal phase of swallowing. Eleven patients with Parkinson's disease and 9 healthy subjects were investigated by electromyography (EMG) and oesophageal scintigraphy. The study demonstrates delayed triggering of swallowing reflex (543 +/- 84 ms in patients with PD vs. 230 +/- 66 ms in controls, p < 0.05) and prolongation of laryngeal movement (1880 +/- 140 ms vs. 1349 +/- 154 ms, p < 0.05). The prolongation of the oesophageal phase of swallowing with predilection to retention of water in lower one/third part of esophagus (12.45 +/- 2.45 s vs. 6.45 +/- 1.18 s, p < 0.001) was observed. The dysphagia limit, that is the maximum amount of water swallowed at once, was also evaluated (all normal subjects are able to swallow 20 ml water or more at once). In the studied patients with Parkinson's disease it was 4.5 +/- 0.86 ml. These results evidently and objectively indicate the presence of swallowing disorders in Parkinson's disease. Dysphagia was observed in all studied patients, although only 8 of them complained about it. In other 3 cases the impairment of swallowing was subclinical and it was connected with prolongation of oesophageal phase.

译文

吞咽障碍是帕金森氏病晚期的常见症状,这种功能的严重缺陷可能会导致吸入肺炎,食物摄入问题和恶病痛。这项研究的目的是评估吞咽的反射和口腔,咽,食道阶段。通过肌电图 (EMG) 和食管闪烁显像检查了11例帕金森氏病患者和9例健康受试者。该研究表明吞咽反射的延迟触发 (PD患者为543/- 84 ms,对照组为230/- 66 ms,p <0.05) 和喉运动的延长 (1880/- 140 ms与1349/- 154 ms,p <0.05)。观察到食管下半部分吞咽阶段的延长,并倾向于保留水 (12.45/- 2.45 s vs. 6.45/- 1.18 s,p <0.001)。还评估了吞咽困难的极限,即一次吞咽的最大水量 (所有正常受试者都能够一次吞咽20毫升或更多的水)。在研究的帕金森氏病患者中,4.5为/-0.86毫升。这些结果明显且客观地表明帕金森氏病中存在吞咽障碍。在所有研究的患者中均观察到吞咽困难,尽管其中只有8人抱怨吞咽困难。在其他3例中,吞咽障碍是亚临床的,并且与食管期的延长有关。

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