Park H, Conklin J L
University of Iowa College of Medicine, Department of Internal Medicine, 4547 John Colloton Pavilion, Iowa City, IA 52242, USA.
Curr Gastroenterol Rep. 1999 Jun;1(3):186-97. doi: 10.1007/s11894-999-0033-3.
The esophagus is a muscular conduit connecting the pharynx and the stomach. Its function is controlled by an intrinsic nervous system and by input from the central nervous system through the vagus nerve. Peristalsis in its striated muscle is directed by sequential vagal excitation arising in the brain stem, whereas peristalsis in its smooth muscle involves complex interactions among the central and peripheral neural systems and the smooth muscle elements of the esophagus. The peripheral neuronal elements responsible for producing esophageal off-response, relaxation of the lower esophageal sphincter, and hyperpolarization of the circular esophageal muscle cells reside in the myenteric plexus of the esophagus. For many years these nerves were considered nonadrenergic and noncholinergic because the inhibitory neurotransmitter released on their activation was unknown. We now know that nitric oxide or a related compound is that inhibitory neurotransmitter. The primary excitatory neurotransmitter controlling esophageal motor function is acetylcholine. Some disorders of esophageal motor function, including diffuse esophageal spasm and achalasia, may result from defects in or an imbalance between these excitatory and inhibitory neuromuscular systems.
食管是连接咽和胃的肌性管道。其功能由内在神经系统以及通过迷走神经从中枢神经系统传入的信号控制。其横纹肌的蠕动由脑干产生的顺序性迷走神经兴奋引导，而其平滑肌的蠕动涉及中枢和外周神经系统以及食管平滑肌成分之间的复杂相互作用。负责产生食管迟发反应、食管下括约肌松弛和食管环形肌细胞超极化的外周神经元成分位于食管肌间神经丛。多年来，这些神经被认为是非肾上腺素能和非胆碱能的，因为其激活时释放的抑制性神经递质尚不清楚。我们现在知道一氧化氮或一种相关化合物就是那种抑制性神经递质。控制食管运动功能的主要兴奋性神经递质是乙酰胆碱。一些食管运动功能障碍，包括弥漫性食管痉挛和贲门失弛缓症，可能是由这些兴奋性和抑制性神经肌肉系统的缺陷或失衡所致。
