Anderson K O, Dalton C B, Bradley L A, Richter J E
Department of Medicine (Gastroenterology), Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27103.
Dig Dis Sci. 1989 Jan;34(1):83-91. doi: 10.1007/BF01536159.
The present study was designed to explore the relationship between psychological stress and esophageal motility disorders. Nineteen non-cardiac chest pain patients (10 with the nutcracker esophagus and nine with normal baseline manometry) and 20 healthy control subjects were administered two acute stressors: intermittent bursts of white noise and difficult cognitive problems. The results indicated that the esophageal contraction amplitudes and levels of anxiety-related behaviors of non-cardiac chest pain patients and control subjects were significantly greater during the stressors than during baseline periods. All patients demonstrated significantly greater (P less than 0.01) increases in contraction amplitude and anxiety-related behavior during cognitive problems than during the noise stressor. The nutcracker esophagus patients showed a greater increase in contraction amplitude during the problems (23.50 +/- 9.42 mm Hg, X +/- SE) than control subjects (P less than 0.01), while the amplitude changes of chest pain patients with normal baseline manometry were not significantly greater than that of control subjects (9.00 +/- 1.91 mm Hg). The present results identified an increase in contraction amplitude as the primary esophageal response to stress. The possible interaction of esophageal contraction abnormalities, psychological stress, and the perception of chest pain is discussed.
本研究旨在探讨心理压力与食管动力障碍之间的关系。对19名非心源性胸痛患者（10名胡桃夹食管患者和9名基础测压正常者）和20名健康对照者施加两种急性应激源：间歇性白噪声突发和困难的认知问题。结果表明，在应激源期间，非心源性胸痛患者和对照者的食管收缩幅度及焦虑相关行为水平显著高于基线期。所有患者在认知问题期间的收缩幅度和焦虑相关行为的增加均显著大于（P<0.01）噪声应激源期间。胡桃夹食管患者在认知问题期间的收缩幅度增加（23.50±9.42 mmHg，X±SE）大于对照者（P<0.01），而基础测压正常的胸痛患者的幅度变化与对照者相比无显著差异（9.00±1.91 mmHg）。目前的结果确定收缩幅度增加是食管对应激的主要反应。本文还讨论了食管收缩异常、心理压力和胸痛感知之间可能的相互作用。
