Upper esophageal sphincter function during gastroesophageal reflux events revisited
Upper esophageal sphincter function during gastroesophageal reflux events revisited
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DOI：
10.1152/ajpgi.2000.279.2.g262
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发表时间：
2000-08-01
影响因子：
4.5
通讯作者：
Shaker, R
中科院分区：
文献类型：
--
作者：
Torrico, S;Kern, M;Shaker, R
胃食管反流事件期间上食管括约肌（UES）功能尚未完全阐明，因为先前针对该问题的研究得出了相互矛盾的结果。我们重新检查了UES压力对反流事件引起的食管腔内压力和pH变化的反应。我们研究了14名健康无症状志愿者（年龄49 +/- 6岁）和7名胃食管反流病患者（年龄48 +/- 5岁）。在摄入1，000卡路里的膳食前1小时和餐后2小时，同时以仰卧位监测食管远端、中段和近端的UES压力、食管内压力和pH值。通过发生突然反流诱导的食管内压升高（IPI），共确定了321起反流事件; 285起事件发生在患者中，36起发生在对照受试者中。在对照受试者中，36例IPI事件中的33例和患者中，285例IPI事件中的252例与pH值下降相关。在患者和对照受试者中，无论pH值是否下降，所有IPI事件中分别有99%和100%与UES压力突然升高相关（分别为34 +/- 2和27 +/- 6 mmHg）。最大UES压力增加超过反流前值的平均百分比范围为66%-96%（对照受试者）和34%-122%（患者）。由酸性和非酸性反流事件诱导的IPI引起强烈的UES收缩反应。
Upper esophageal sphincter (UES) function during gastroesophageal reflux events is not completely elucidated because previous studies addressing this issue yielded conflicting results. We reexamined the UES pressure response to intraluminal esophageal pressure and pH changes induced by reflux events. We studied 14 healthy, asymptomatic volunteers (age 49 +/- 6 yr) and 7 gastroesophageal reflux disease patients (age 48 +/- 5 yr). UES pressure, intraesophageal pressure, and pH were monitored at the distal, middle, and proximal esophagus concurrently in the supine position 1 h before and 2 h after a 1,000-calorie meal. A total of 321 reflux events were identified by the development of abrupt reflux-induced intraesophageal pressure increase (IPI); 285 events occurred in patients and 36 in control subjects. In control subjects 33 of 36 and in patients 252 of 285 IPI events were associated with a pH drop. Among patients and control subjects, 99% and 100%, respectively, of all IPI events irrespective of pH drop were associated with abrupt increase in UES pressure (34 +/- 2 and 27 +/- 6 mmHg, respectively). The average percentage of maximum UES pressure increase over prereflux values ranged between 66% and 96% (control subjects) and 34% and 122% (patients). IPIs induced by both acidic and nonacidic reflux events evoke strong UES contractile responses.