Vakil N B, Kahrilas P J, Dodds W J, Vanagunas A
Department of Medicine, Northwestern University Medical School, Chicago, Illinois.
Am J Gastroenterol. 1989 Jun;84(6):606-10.
Manometric studies of the upper esophageal sphincter (UES) were done on 17 volunteer subjects and 16 patients with endoscopically evident esophagitis. Subjects entered one or both of two protocols designed to assess the effect of esophageal acid exposure on UES pressure. In protocol 1, continuous 3-h postprandial recordings were obtained; a modified sleeve sensor was used to measure UES pressure, and an intraluminal pH electrode was used to detect occurrences of spontaneous gastroesophageal acid reflux. In protocol 2, UES pressure was continuously monitored during a 10-min control period, followed by a 25-min period of esophageal perfusion with 0.1 N HCl. Our findings were that: 1) basal UES pressure measured during the 3-h recording was similar in the normal volunteers and in the group of patients with esophagitis, 2) episodes of spontaneous gastroesophageal acid reflux were not associated with a change in UES pressure in either the normal volunteers or in the patients with esophagitis, and 3) esophageal perfusion with HCl did not affect the UES pressure in either group, although severe heartburn occurred in most of the esophagitis patients. We conclude that the upper esophageal sphincter exhibits normal basal pressure in patients with esophagitis and that esophageal acid exposure, either spontaneous or experimental, does not affect UES pressure in normal volunteers or in patients with esophagitis.
对17名志愿者和16名内镜检查显示有食管炎的患者进行了食管上括约肌（UES）测压研究。受试者参与了一项或两项旨在评估食管酸暴露对UES压力影响的方案。在方案1中，餐后连续记录3小时；使用改良的袖带传感器测量UES压力，并用腔内pH电极检测自发性胃食管酸反流的发生情况。在方案2中，在10分钟的对照期内持续监测UES压力，随后用0.1N盐酸对食管进行25分钟的灌注。我们的研究结果如下：1）在3小时记录期间测量的基础UES压力在正常志愿者和食管炎患者组中相似；2）无论是正常志愿者还是食管炎患者，自发性胃食管酸反流发作均与UES压力变化无关；3）尽管大多数食管炎患者出现了严重的烧心症状，但用盐酸灌注食管对两组的UES压力均无影响。我们得出结论，食管炎患者的食管上括约肌基础压力正常，并且无论是自发性还是实验性的食管酸暴露，均不会影响正常志愿者或食管炎患者的UES压力。
