Jørgensen F, Boesen F, Andersen E B, Hesse B
Department of Clinical Physiology, Hillerød Hospital, Denmark.
Clin Physiol. 1991 Jan;11(1):83-92. doi: 10.1111/j.1475-097x.1991.tb00656.x.
Oesophageal function was examined by radionuclide transit measurements in 15 patients with severe autonomic deficiency and orthostatic hypothension and 23 healthy volunteers. Seven of the patients were re-examined after treatment for 3 weeks with fludrocortisone acetate (Florinef). Six patients and five control subjects were evaluated before and after i.v. administration of atropine. The mean transit time (MTT) was prolonged (P less than 0.007) and the residual activity increased (P = 0.038) in the patients compared with the control group. Prolonged MTT was associated with oesophageal symptoms. Treatment of orthostatic hypotension with fludrocortisone acetate significantly reduced MTT. Atropine increased MTT and residual activity. The increase in heart rate after atropine was correlated in the patients with MTT before treatment. The results demonstrate the frequent presence of impaired oesophageal function in patients with severe autonomic dysfunction, irrespective of aetiology. The impairment seems to be closely related to parasympathetic insufficiency. The improvement after fludrocortisone may suggest an influence of ion balance on oesophageal function in these patients.
通过放射性核素转运测量法对15例严重自主神经功能缺陷和体位性低血压患者及23名健康志愿者的食管功能进行了检查。7例患者在接受醋酸氟氢可的松（氟氢可的松）治疗3周后再次接受检查。对6例患者和5名对照受试者在静脉注射阿托品前后进行了评估。与对照组相比，患者的平均转运时间（MTT）延长（P<0.007），残留活性增加（P = 0.038）。MTT延长与食管症状相关。用醋酸氟氢可的松治疗体位性低血压可显著缩短MTT。阿托品可增加MTT和残留活性。患者注射阿托品后心率的增加与治疗前的MTT相关。结果表明，无论病因如何，严重自主神经功能障碍患者中经常存在食管功能受损的情况。这种损害似乎与副交感神经功能不全密切相关。醋酸氟氢可的松治疗后的改善可能提示离子平衡对这些患者食管功能有影响。
