Smout A J, Devore M S, Dalton C B, Castell D O
Division of Gastroenterology, Jefferson Medical College, Philadelphia, Pa.
Dig Dis Sci. 1992 Apr;37(4):598-602. doi: 10.1007/BF01307586.
The effects of nifedipine (20 mg orally) on esophageal body resting tone and perception of esophageal distension were compared with those of placebo in 10 healthy volunteers, using a double-blind crossover design. A 3-cm silicon balloon positioned 10 cm above the lower esophageal sphincter was inflated with 2-20 ml of air, in 2-ml increments. The subjects scored their chest sensations, while pressure in the balloon was continuously recorded. In each experiment three series of measurements were made, at baseline and 15 and 30 min after administration of nifedipine or placebo. Bench tests were run to determine pressure-to-volume relationships for each of the balloons used in the study. Thirty minutes after nifedipine ingestion, a significant decrease in systolic blood pressure (from 112.6 +/- 2.3 to 99.0 +/- 2.0 mm Hg) was observed. Amplitude and duration of esophageal peristaltic contractions were significantly decreased by nifedipine (from 128.1 +/- 16.7 to 98.7 +/- 10.6 mm Hg and from 3.9 +/- 0.3 to 3.3 +/- 0.2 sec, respectively). With balloon volumes of 8 ml and higher, balloon pressures were higher with the balloon in the esophagus than on the bench, the difference being determined by the compliance of the esophagus. This difference rose from 18.5 +/- 6.8 to 40.2 +/- 7.2 mm Hg (8-20 ml) with placebo and from 23.1 +/- 3.7 to 35.9 +/- 5.8 mm Hg with nifedipine. No significant differences between nifedipine and placebo were found. The esophageal sensation scores increased linearly with increasing balloon volume from 6 ml onwards. Nifedipine had no significant effect on the perception of esophageal balloon distension.
采用双盲交叉设计，在10名健康志愿者中比较了硝苯地平（口服20毫克）与安慰剂对食管体部静息张力和食管扩张感觉的影响。在下食管括约肌上方10厘米处放置一个3厘米的硅气球，用2至20毫升空气以2毫升的增量充气。受试者对胸部感觉进行评分，同时持续记录气球内的压力。在每个实验中，在基线以及给予硝苯地平或安慰剂后15分钟和30分钟进行三组测量。进行基准测试以确定研究中使用的每个气球的压力-体积关系。服用硝苯地平30分钟后，观察到收缩压显著下降（从112.6±2.3毫米汞柱降至99.0±2.0毫米汞柱）。硝苯地平使食管蠕动收缩的幅度和持续时间显著降低（分别从128.1±16.7毫米汞柱降至98.7±10.6毫米汞柱，从3.9±0.3秒降至3.3±0.2秒）。当气球体积为8毫升及以上时，食管内气球的压力高于基准测试时的压力，差异由食管的顺应性决定。安慰剂组该差异从18.5±6.8毫米汞柱（8 - 20毫升）升至40.2±7.2毫米汞柱，硝苯地平组从23.1±3.7毫米汞柱升至35.9±5.8毫米汞柱。硝苯地平和安慰剂之间未发现显著差异。从6毫升起，食管感觉评分随气球体积增加呈线性增加。硝苯地平对食管气球扩张的感觉无显著影响。
