PULMONARY-FUNCTION AND ACID APPLICATION IN THE ESOPHAGUS
PULMONARY-FUNCTION AND ACID APPLICATION IN THE ESOPHAGUS
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DOI：
10.1378/chest.90.3.358
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发表时间：
1986-09-01
期刊：
影响因子：
9.6
通讯作者：
BUNDGAARD, A
中科院分区：
文献类型：
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作者：
ANDERSEN, LI;SCHMIDT, A;BUNDGAARD, A
在一项双盲研究中，测量了三组患者的食道酸应用对肺功能的影响。第1组由10名患有食管炎但无肺部疾病的患者组成，第2组为21名患有支气管哮喘但没有食管炎的患者，第3组为8名同时患有食管炎和支气管哮喘的患者。通过肺总容量（TLC）、气道阻力（Raw）、残气量（RV）和峰值兴奋流量（PEF）来评估肺功能。在一次试验中，在以下五次测量这四个参数：插入食管导管之前和之后；滴注50ml等渗氯化钠溶液之后；滴注50ml 0.1N盐酸后；静脉注射阿托品（0.01毫克/公斤体重）后。仅在第 3 组中观察到，在滴注 HCl 后，PEF 显着降低（Wilcoxon 检验，p < 0.02；Mann-Whitney 检验，p < 0.002），而 Raw 显着增加（分别为 p < 0.02 和 p < 0.002）。其他组的变化很小，没有任何规律模式。第三组中的 6 名患者在接受阿托品（0.01 mg/kg，每日两次）预处理三天后接受了另一项试验。现在，滴注酸不会对 PEF 或 Raw 产生任何变化 (p < 0.001)。我们的结论是，当食管中存在酸时，支气管哮喘和严重食管炎患者会出现适度的支气管收缩。阿托品抑制这种支气管收缩，表明迷走神经介导。
The effect of acid application in the esophagus on pulmonary function was measured in three groups of patients in a double-blind investigation. Group 1 consisted of ten patients with esophagitis but without pulmonary disease, group 2 was 21 patients with bronchial asthma without esophagitis, and group 3 was eight patients with both esophagitis and bronchial asthma. Pulmonary function was assessed by total lung capacity (TLC), airway resistance (Raw), residual volume (RV), and peak excitatory flow (PEF). The four parameters were measured at the following five times during a single trial: before and after insertion of an esophageal cathether: after instillation of 50 ml of isotonic sodium chloride solution; after instillation of 50 ml of 0.1 N hydrochloric acid; and after intravenous injection of atropine (0.01 mg/kg of body weight). A significant decrease (the Wilcoxon test, p < 0.02; and the Mann-Whitney test, p < 0.002) in PEF and a significant increase (p < 0.02 and p < 0.002, respectively) in Raw after instillation of HCl were seen only in group 3. Changes in the other groups were small and without any regular pattern. Six of the patients in the third group accepted another trial after three days of pretreatment with atropine (0.01 mg/kg twice daily). Now instillation of acid did not produce any change in PEF or Raw (p < 0.001). We conclude that a modest bronchoconstriction when acid is present in the esophagus is seen in patients with bronchial asthma and severe esophagitis. Atropine inhibits this bronchoconstriction, indicating vagal mediation.