EFFECT OF SLEEP, SPONTANEOUS GASTROESOPHAGEAL REFLUX, AND A MEAL ON UPPER ESOPHAGEAL SPHINCTER PRESSURE IN NORMAL HUMAN VOLUNTEERS
EFFECT OF SLEEP, SPONTANEOUS GASTROESOPHAGEAL REFLUX, AND A MEAL ON UPPER ESOPHAGEAL SPHINCTER PRESSURE IN NORMAL HUMAN VOLUNTEERS
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DOI：
10.1016/0016-5085(87)90143-0
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发表时间：
1987-02-01
期刊：
影响因子：
29.4
通讯作者：
ARNDORFER, RC
中科院分区：
文献类型：
--
作者：
KAHRILAS, PJ;DODDS, WJ;ARNDORFER, RC
由于记录食管上括约肌压力的固有困难，对正常的食管上括约肌生理知之甚少。在这项研究中，我们使用改良的套筒装置连续记录8名正常志愿者的食管上括约肌压力。同时记录食管内pH值和脑电图活动，以记录自发性胃食管反流和睡眠的发生。在基线记录一小时后，受试者进食，然后重新开始记录额外的7小时，在此期间受试者有部分时间睡觉。每10分钟测量平均食管上括约肌压力。盲读脑电图记录以了解睡眠的存在和阶段。然后，睡眠时间与测压图相关联。在清醒、第一阶段睡眠和深度睡眠时，平均食管上括约肌压为40±。17 (sd), 20 .+-。17和8，+-。3毫米汞柱。餐后或自发性胃食管反流发作时，食管上括约肌压力未发生显著变化。在休息和睡眠期间，每次吸气时，食管上括约肌的压力都会短暂增加，这一反应与食道上括约肌的功能之一是在呼吸时将空气排出食道的假设相一致。食道上括约肌压力在睡眠期间显著下降，这可能具有重要意义，因为这减少了夜间反流和潜在误吸的障碍。
Owing to the inherent difficulties of recording upper esophageal sphincter pressure, little is known about normal upper esophageal sphincter physiology. In this study we used a modified sleeve device to record upper esophageal sphincter pressure continuously in 8 normal volunteers. Intraesophageal pH and electroencephalogram activity were also recorded to document the occurrence of spontaneous gastroesophageal reflux and sleep. After an hour of baseline recording, the subjects ate a meal Recording was then resumed for an additional 7 h during which period the subjects slept part of the time. The mean upper esophageal sphincter pressure was measured for each 10-min epoch. Electroencephalogram recordings were read blindly for the presence and stage of sleep. Periods of sleep were then correlated with the manometric tracings. Mean upper esophageal sphincter pressure during wakefulness, stage 1 sleep, and deeper sleep was 40 .+-. 17 (SD), 20 .+-. 17, and 8 .+-. 3 mmHg, respectively. A significant change in upper esophageal sphincter pressure did not occur postprandially or during episodes of spontaneous gastroesophageal reflux. Upper esophageal sphincter pressure was observed to increase transiently with each inspiration during periods of restfulness and sleep, a response consistent with the hypothesis that one function of the upper esophageal sphincter is to exclude air from the esophagus during respiration. The demonstration that upper esophageal sphincter pressure falls markedly during sleep may have significance in that this diminishes the barrier to nocturnal regurgitation and potential aspiration.