恰加斯病中下食管括约肌的胆碱能神经支配

Cholinergic innervation of the lower esophageal sphincter in Chagas' disease.

Dantas R O, Godoy R A, Oliveira R B, Meneghelli U G, Troncon L E

Departamento de Clínica Médica, Faculdade de Medicina de Riberirão Preto, Universidade de São Paulo, Brasil.

Braz J Med Biol Res. 1987;20(5):527-32.

Abstract

The effect of 12 micrograms/kg iv atropine on the lower esophageal sphincter (LES) pressure was studied by continuous perfusion manometry in 14 Chagasic patients, 9 controls, and 3 patients with achalasia, and the effect of 3 ml iv saline was studied in 7 Chagasic patients. 2. Resting LES pressure did not differ between Chagasic patients (11.5 +/- 4.1 mmHg) and controls (15.9 +/- 4.9 mmHg, P greater than 0.05). 3. Atropine caused a significant decrease in LES pressure in both Chagasics and controls, but the reduction in controls was significantly greater (56%) than in Chagasics (25%). 4. Saline did not change the LES pressure of Chagasics. Atropine caused a similar reduction of LES pressure in achalasia patients (49%) and in controls (56%). 5. These results suggest that the cholinergic excitatory nerves are impaired in Chagas' disease, but not in achalasia, where they were either normal or only minimally impaired.

摘要

通过连续灌注测压法，对14例恰加斯病患者、9例对照者和3例贲门失弛缓症患者研究了静脉注射12微克/千克阿托品对食管下括约肌（LES）压力的影响，并对7例恰加斯病患者研究了静脉注射3毫升生理盐水的影响。2. 恰加斯病患者的静息LES压力（11.5±4.1毫米汞柱）与对照者（15.9±4.9毫米汞柱，P>0.05）之间无差异。3. 阿托品使恰加斯病患者和对照者的LES压力均显著降低，但对照者的降低幅度（56%）显著大于恰加斯病患者（25%）。4. 生理盐水未改变恰加斯病患者的LES压力。阿托品使贲门失弛缓症患者（49%）和对照者（56%）的LES压力降低幅度相似。5. 这些结果表明，恰加斯病中胆碱能兴奋性神经受损，但贲门失弛缓症中未受损，贲门失弛缓症中的胆碱能兴奋性神经要么正常，要么仅轻微受损。