Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Dis Esophagus. 2010 Nov;23(8):670-4. doi: 10.1111/j.1442-2050.2010.01066.x.
Chagas' disease and idiopathic achalasia patients have similar impairment of distal esophageal motility. In Chagas' disease, the contractions occurring in the distal esophageal body are similar after wet or dry swallows. Our aim in this investigation was to evaluate the effect of wet swallows and dry swallows on proximal esophageal contractions of patients with Chagas' disease and with idiopathic achalasia. We studied 49 patients with Chagas' disease, 25 patients with idiopathic achalasia, and 33 normal volunteers. We recorded by the manometric method with continuous water perfusion the pharyngeal contractions 1 cm above the upper esophageal sphincter and the proximal esophageal contractions 5 cm from the pharyngeal recording point. Each subject performed in duplicate swallows of 3-mL and 6-mL boluses of water and dry swallows. We measured the time between the onset of pharyngeal contractions and the onset of proximal esophageal contractions (pharyngeal-esophageal time [PET]), and the amplitude, duration, and area under the curve (AUC) of proximal esophageal contractions. Patients with Chagas' disease and with achalasia had longer PET, lower esophageal proximal contraction amplitude, and lower AUC than controls (P≤ 0.02). In Chagas' disease, wet swallows caused shorter PET, higher amplitude, and higher AUC than dry swallows (P≤ 0.03).There was no difference between swallows of 3- or 6-mL boluses. There was no difference between patients with Chagas' disease and with idiopathic achalasia. We conclude that patients with Chagas' disease and with idiopathic achalasia have a delay in the proximal esophageal response and lower amplitude of the proximal esophageal contractions.
恰加斯病和特发性贲门失弛缓症患者的远端食管运动功能均有类似的损害。在恰加斯病中，湿吞或干吞后，远端食管体的收缩相似。我们在这项研究中的目的是评估湿吞和干吞对恰加斯病和特发性贲门失弛缓症患者近端食管收缩的影响。我们研究了 49 例恰加斯病患者、25 例特发性贲门失弛缓症患者和 33 名正常志愿者。我们通过连续水灌注的测压法记录咽上部括约肌上方 1cm 处的咽收缩和距咽记录点 5cm 处的近端食管收缩。每位受试者重复进行 3ml 和 6ml 水团的吞咽，并进行干吞咽。我们测量了咽收缩开始和近端食管收缩开始之间的时间（咽食管时间[PET]），以及近端食管收缩的幅度、持续时间和曲线下面积（AUC）。恰加斯病和贲门失弛缓症患者的 PET 时间较长，食管下段近端收缩幅度较低，AUC 较低（P≤0.02）。恰加斯病患者湿吞咽时 PET 时间较短，幅度和 AUC 较高，而干吞咽时则较低（P≤0.03）。3ml 和 6ml 水团吞咽之间没有差异。恰加斯病和特发性贲门失弛缓症患者之间也没有差异。我们得出结论，恰加斯病和特发性贲门失弛缓症患者近端食管的反应延迟，近端食管收缩的幅度较低。
