Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation
Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation
复制标题
DOI：
10.1152/ajpgi.00301.2002
复制
发表时间：
2003-02-01
影响因子：
4.5
通讯作者：
Kahrilas, PJ
中科院分区：
文献类型：
--
作者：
Pouderoux, P;Verdier, E;Kahrilas, PJ
食管下括约肌 (LES) 松弛和食管体抑制在食管蠕动期间同时发生，但不一定在咽部刺激或短暂 LES 松弛 (tLESR) 期间同时发生。这项研究探讨了这些关系及其对反流的影响。对九名年轻志愿者进行了研究。建立人工高压区 (HPZ)，并在 LES 附近 8 和 5 cm 处记录 pH 值。通过注水和用液体或气体使胃扩张来刺激咽部。记录蠕动、咽部刺激和自发事件。在 100% 的试验中，吞咽可以放松 LES（80% 的 HPZ）并且不会引起反流。在三分之二的试验中，咽部刺激使 LES 放松，对 HPZ 没有影响，并且不会引起反流。胃扩张与 117 次 tLESR 相关，其中 48% 与胃酸反流有关，32% 与气体反流有关；对 HPZ 没有影响。我们得出结论，LES 松弛是反流的必要但非充分条件。 LES 松弛和食管体抑制是独立事件，可能同时发生（吞咽）或分离发生（tLESR）。
Lower esophageal sphincter (LES) relaxation and esophageal body inhibition co-occur during esophageal peristalsis but not necessarily during pharyngeal stimulation or transient LES relaxation (tLESR). This study examined these relationships and the impact on reflux. Nine young volunteers were studied. An artificial high-pressure zone (HPZ) was established, and pH was recorded 8 and 5 cm proximal to the LES. Pharyngeal stimulation was by water injection and gastric distension with liquid or gas. Peristalsis, pharyngeal stimulation, and spontaneous events were recorded. Swallowing relaxed the LES in 100% of trials (the HPZ in 80%) and caused no reflux. Pharyngeal stimulation relaxed the LES in two-thirds of trials, had no effect on the HPZ, and caused no reflux. Gastric distension was associated with 117 tLESRs, 48% with acid reflux, and 32% with gas reflux; there was no effect on the HPZ. We conclude that LES relaxation is a necessary but not sufficient condition for reflux. LES relaxation and esophageal body inhibition are independent events that may be concurrent (swallowing) or dissociated (tLESR).