De Caestecker J S, Pryde A, Heading R C
Department of Medicine, Royal Infirmary, Edinburgh.
Gut. 1988 Aug;29(8):1029-34. doi: 10.1136/gut.29.8.1029.
Sixty consecutive patients referred for evaluation of non-cardiac chest pain had oesophageal manometry. Motility was assessed basally, after edrophonium 80 micrograms/kg iv and during oesophageal perfusion with 0.1 N HCl at 6 and 14 ml/min for eight and seven minutes respectively. A positive response, defined as symptom reproduction with or without abnormal motility, was present in 21 patients (35%) after acid perfusion and 12 (20%) after edrophonium. Eleven of the 12 patients responding to edrophonium also responded to acid perfusion, including most of the patients with primary motility disorders. Significantly greater increases in peristaltic duration, but not amplitude, were recorded after edrophonium (p less than 0.01) and acid perfusion (p less than 0.05) in positive responders, compared with non-responders. Results indicate that acid perfusion during oesophageal manometry may be a more useful stress test than edrophonium and that the mechanism of symptom production may be similar.
连续60例因非心源性胸痛前来评估的患者接受了食管测压检查。分别在基础状态下、静脉注射80微克/千克依酚氯铵后以及食管分别以6毫升/分钟和14毫升/分钟的速度灌注0.1N盐酸8分钟和7分钟期间评估运动功能。酸灌注后21例患者（35%）出现阳性反应，定义为伴有或不伴有异常运动功能的症状再现，依酚氯铵后12例患者（20%）出现阳性反应。对依酚氯铵有反应的12例患者中有11例对酸灌注也有反应，包括大多数原发性运动功能障碍患者。与无反应者相比，阳性反应者在依酚氯铵（p<0.01）和酸灌注（p<0.05）后记录到蠕动持续时间显著增加，但幅度未增加。结果表明，食管测压期间的酸灌注可能是比依酚氯铵更有用的应激试验，且症状产生机制可能相似。
