Inhibition of progressing primary esophageal peristalsis by pharyngeal water stimulation in humans.
Inhibition of progressing primary esophageal peristalsis by pharyngeal water stimulation in humans.
复制标题
通过咽部水刺激抑制人类初级食管蠕动。
DOI：
10.1053/gast.1996.v110.pm8566588
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发表时间：
1996
期刊：
影响因子：
29.4
通讯作者：
Shaker,R
中科院分区：
文献类型：
--
作者：
Trifan,A;Ren,J;Arndorfer,R;Hofmann,C;Bardan,E;Shaker,R
背景与目的由咽部发出的感觉冲动对吞咽器官产生不同的影响。它们对食管下括约肌有抑制作用，但对食管上括约肌有兴奋作用。本研究旨在系统探讨水刺激引起的咽部感觉冲动对食管蠕动进展的影响。方法对16名健康青年志愿者进行平卧位研究。证实存在正常的蠕动。食管下括约肌上方3、6、9、12、15、18 cm处记录食管蠕动。咽刺激是通过在食管上括约肌上方2厘米处的咽部注射预定的阈值体积来进行的。注射的时间与在各自的记录地点由干燕子引起的蠕动波到达的时间一致。结果阈值体积（0.5 +/- 0.1 mL）对食管横纹肌和平滑肌的蠕动均有抑制作用。局部咽麻醉阻断了这种抑制作用（P < 0.01）。结论水注射引起的咽部感觉冲动可抑制原发性食管蠕动的进展。虽然这些发现的临床意义尚未确定，但它们可能解释了一些食管蠕动失败的机制。（胃肠病学1996年2月；110(2):419-23）
BACKGROUND & AIMSSensory impulses initiated from the pharynx exert differing effects on the deglutitive apparatus. They have an inhibitory effect on the lower esophageal sphincter but an excitatory effect on the upper esophageal sphincter. The aim of this study was to systematically investigate the effect of pharyngeal sensory impulses evoked by water stimulation on the progressing esophageal peristalsis.METHODSSixteen healthy young volunteers were studied in the supine position. The presence of normal peristalsis was verified. Esophageal peristalsis was recorded 3, 6, 9, 12, 15, and 18 cm above the lower esophageal sphincter. Pharyngeal stimulation was performed by injecting a predetermined threshold volume into the pharynx 2 cm above the upper esophageal sphincter, directed posteriorly. The injections were timed to coincide with the arrival of the peristaltic wave induced by dry swallows at respective recording sites.RESULTSInjection of the threshold volume (0.5 +/- 0.1 mL) stopped the progression of peristalsis at both the striated and smooth muscle esophagus. Topical pharyngeal anesthesia blocked this inhibitory effect (P < 0.01).CONCLUSIONSSensory impulses initiated from the pharynx evoked by water injection inhibit the progression of primary esophageal peristalsis. Although the clinical significance of these findings is not determined, they may explain the mechanism of some of the failed esophageal peristalsis. (Gastroenterology 1996 Feb;110(2):419-23)