Dantas R O, Godoy R A, Oliveira R B, Meneghelli U G, Troncon L E
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
Dig Dis Sci. 1990 Apr;35(4):508-12. doi: 10.1007/BF01536927.
It is known that lower esophageal sphincter (LES) pressure in patients with idiopathic achalasia is higher than in normal subjects, but in patients with Chagas' disease, who have esophageal disease with similar clinical, manometric, and radiologic results, studies of LES pressure show contradictory findings. We measured the LES pressure in 118 patients with chronic Chagas' disease, 14 patients with idiopathic achalasia, and 50 control subjects using a perfused catheter and the stationary pull-through (SPT) technique. The patients with Chagas' disease had normal esophageal radiologic examination (group A, N = 50), delay in esophageal clearance without dilatation (group B, N = 41), or delay in esophageal clearance with dilatation (group C, N = 27). The LES pressure of Chagas' disease patients of group A (18.6 +/- 9.1 mm Hg, mean +/- SD), group B (17.8 +/- 9.7 mm Hg), and group C (21.6 +/- 10.1 mm Hg) was lower (P less than 0.001) than the LES pressure of the controls (24.9 +/- 10.2 mm Hg). In patients with idiopathic achalasia, the LES pressure (40.7 +/- 17.8 mm Hg) was higher than in control subjects (P less than 0.01) and Chagas' disease patients (P less than 0.001). We conclude that the LES pressure of patients with Chagas' disease tended to be lower than that of control subjects and achalasia patients.
已知特发性贲门失弛缓症患者的食管下括约肌（LES）压力高于正常受试者，但对于患有恰加斯病（Chagas' disease）的患者，他们患有具有相似临床、测压和放射学结果的食道疾病，关于LES压力的研究结果相互矛盾。我们使用灌注导管和静态牵拉通过（SPT）技术测量了118例慢性恰加斯病患者、14例特发性贲门失弛缓症患者和50名对照受试者的LES压力。恰加斯病患者的食管放射学检查正常（A组，N = 50），食管清除延迟但无扩张（B组，N = 41），或食管清除延迟且有扩张（C组，N = 27）。A组（18.6 +/- 9.1 mmHg，平均值 +/- 标准差）、B组（17.8 +/- 9.7 mmHg）和C组（21.6 +/- 10.1 mmHg）的恰加斯病患者的LES压力低于对照组（24.9 +/- 10.2 mmHg）（P < 0.001）。在特发性贲门失弛缓症患者中，LES压力（40.7 +/- 17.8 mmHg）高于对照受试者（P < 0.01）和恰加斯病患者（P < 0.001）。我们得出结论，恰加斯病患者的LES压力往往低于对照受试者和贲门失弛缓症患者。
