Dantas R O, de Godoy R A, de Oliveira R B, Meneghelli U G, Troncon L E
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
Acta Physiol Pharmacol Latinoam. 1988;38(2):151-8.
The effect of isosorbide dinitrate (5 mg, sublingually) and of atropine (12 micrograms/kg i.v.) on the lower esophageal sphincter pressure of chagasic patients with esophageal involvement and of control subjects was studied by the manometric method. The pressure was measured at 5 minute intervals for 60 minutes after drug administration. When the effect of isosorbide dinitrate was studied, basal sphincter pressure (mean +/- SEM) was 15.3 +/- 1.9 mmHg in chagasic patients (N = 15) and 25.4 +/- 5.6 mmHg in controls (N = 9) (P greater than 0.05). Isosorbide dinitrate reduced sphincter pressure between 10 and 20 minutes and at 40 minutes in controls, and froM 5 to 60 minutes in chagasics (P less than 0.05). The reduction was more intense in chagasics throughout the time of measurement (P less than 0.05). When the effect of atropine was studied, basal sphincter pressure was 20.6 +/- 1.8 mmHg in chagasic patients (N = 14) and 23.7 +/- 2.5 mmHg in controls (N = 9) (P greater than 0.05). Atropine reduced sphincter pressure both in chagasics and controls, but more intensely so in controls during the first 30 minutes of the study (P less than 0.05). The action of the musculature itself may be the main factor in the maintenance of sphincter pressure in chagasics, with secondary participation of the cholinergic excitatory system.
采用测压法研究了硝酸异山梨酯（5毫克，舌下含服）和阿托品（12微克/千克，静脉注射）对患有食管受累的恰加斯病患者及对照受试者下食管括约肌压力的影响。给药后每隔5分钟测量一次压力，共测量60分钟。在研究硝酸异山梨酯的作用时，恰加斯病患者（N = 15）的基础括约肌压力（平均值±标准误）为15.3±1.9毫米汞柱，对照受试者（N = 9）为25.4±5.6毫米汞柱（P＞0.05）。硝酸异山梨酯使对照受试者在10至20分钟及40分钟时括约肌压力降低，使恰加斯病患者在5至60分钟时括约肌压力降低（P＜0.05）。在整个测量期间，恰加斯病患者的压力降低更为显著（P＜0.05）。在研究阿托品的作用时，恰加斯病患者（N = 14）的基础括约肌压力为20.6±1.8毫米汞柱，对照受试者（N = 9）为23.7±2.5毫米汞柱（P＞0.05）。阿托品使恰加斯病患者和对照受试者的括约肌压力均降低，但在研究的前30分钟内，对照受试者的降低更为显著（P＜0.05）。肌肉组织自身的作用可能是恰加斯病患者维持括约肌压力的主要因素，胆碱能兴奋系统起次要作用。
