Effect of repeated cycles of acute esophagitis and healing on esophageal peristalsis, tone, and length
Effect of repeated cycles of acute esophagitis and healing on esophageal peristalsis, tone, and length
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DOI：
10.1152/ajpgi.00492.2004
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发表时间：
2005-06-01
影响因子：
4.5
通讯作者：
Sifrim, D
中科院分区：
文献类型：
--
作者：
Zhang, X;Geboes, K;Sifrim, D
严重的食管炎与食管体和食管下括约肌的运动异常有关。反流性疾病包括反复发作的粘膜炎症和自发或治疗诱导的愈合。本研究的目的是1)进一步评估急性食管炎对食管蠕动、张力和缩短的影响，2)评估急性食管炎愈合的重复序列对这些运动参数的影响。实验在成年猫身上进行。食管内酸灌注（0.1 N HCl, 80 min）前、后24 h和每7 d进行食管测压和恒压。测压时测量食管长度，用恒压器评估食管体的顺应性。第一次酸灌注后8周和16周采用相同的方法。通过内窥镜、组织病理学和髓过氧化物酶活性评估食管粘膜损伤程度。酸灌注诱导严重食管炎。24 h，远端蠕动收缩消失，食管下括约肌压力降低60%，食管长度缩短1 ~ 2 cm，食管顺应性降低30%。大部分参数在4周内恢复。随后的多次急性损伤引起了类似的内镜下食管炎，但粘膜和肌肉层的炎症浸润和纤维化模式不同，导致较轻的运动障碍。急性实验性食管炎引起严重但可逆的运动功能低下。间隔性的重复急性损伤会引起较轻的运动效应，提示适应性反应。
Severe esophagitis is associated with motor abnormalities in the esophageal body and lower esophageal sphincter. Reflux disease involves repeated episodes of mucosal inflammation and spontaneous or treatment-induced healing. The aims of this study were 1) to further assess changes induced by acute esophagitis on esophageal peristalsis, tone, and shortening and 2) to assess the effect of repeated sequences of acute esophagitis-healing on these motor parameters. Experiments were performed on adult cats. Esophageal manometry and barostat were performed before, 24 h after, and every 7 days after intraesophageal acid perfusion (0.1 N HCl, 80 min). Esophageal length was measured during manometry, and compliance of the esophageal body was assessed with barostat. The identical protocol was performed 8 and 16 wk after the first acid perfusion. The degree of esophageal mucosal damage was evaluated by endoscopy, histopathology, and myeloperoxidase activity. Acid perfusion induced severe esophagitis. At 24 h, distal peristaltic contractions disappeared, lower esophageal sphincter pressure was reduced by 60%, the esophagus length was 1-2 cm shorter, and esophageal compliance was reduced by 30%. Most parameters recovered in 4 wk. Subsequent repeated acute injuries induced similar endoscopic esophagitis but a different pattern of inflammatory infiltration and fibrosis in the mucosa and muscle layers, resulting in milder motor disturbances. Acute experimental esophagitis provokes severe but reversible hypomotility. Spaced repeated acute injuries provoke milder motor effects, suggesting an adaptive response.