Knauer C M, Castell J A, Dalton C B, Nowak L, Castell D O
Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
Dig Dis Sci. 1990 Jun;35(6):774-80. doi: 10.1007/BF01540183.
Extensive physiological studies of swallowing have been carried out in laboratory animals; however, similar studies in humans have been limited by available technology. In this study we describe the use of a solid-state circumferential sphincter transducer to define manometric characteristics of the human pharynx and upper esophageal sphincter (UES). Effects of pharmacologic agents and thermal stimulation are also described. We studied nine normal volunteers on three separate days. All studies were done in the upright position and consisted of a station pull-through of the UES and six wet swallows with the sphincter transducer in the most proximal segment of the UES and a posteriorly oriented single transducer 5 cm proximal in the pharynx. Baseline studies preceded all drug studies. Effects of bethanechol were studied on day 1, cold stimulation and benzonatate on day 2, edrophonium and atropine on day 3. The UES resting pressure showed large intrasubject day-to-day variations; however, mean values did not differ. There were no effects on UES relaxation or swallow coordination with any of the pharmacologic agents, although benzonatate produced multiple pharyngeal contractions.
在实验动物身上已经对吞咽进行了广泛的生理学研究；然而，在人类身上进行的类似研究受到现有技术的限制。在本研究中，我们描述了使用固态环形括约肌换能器来确定人类咽部和食管上括约肌（UES）的测压特征。还描述了药物制剂和热刺激的作用。我们在三天内对九名正常志愿者进行了研究。所有研究均在直立位进行，包括对UES进行一次逐站牵拉，并在UES最近端节段放置括约肌换能器以及在咽部近端5厘米处放置一个向后定向的单个换能器，进行六次湿吞咽。在所有药物研究之前先进行基线研究。第1天研究了氨甲酰甲胆碱的作用，第2天研究了冷刺激和苯佐那酯的作用，第3天研究了依酚氯铵和阿托品的作用。UES静息压力在受试者内部存在较大的每日变化；然而，平均值并无差异。尽管苯佐那酯会引起多次咽部收缩，但任何一种药物制剂对UES松弛或吞咽协调性均无影响。
