Traube M, McCallum R W
Am J Gastroenterol. 1987 Sep;82(9):831-5.
The aim of this study was to examine systematically the manometric characteristics of symptomatic patients with high-amplitude peristaltic esophageal contractions, or the nutcracker esophagus (n = 20), in comparison to normal subjects (n = 30). In both normals and patients, amplitude and duration of contractions were more at 5 cm than at 10 cm above the lower esophageal sphincter. The patients differed significantly from normals not only in amplitude at 5 cm, but also at 10 cm and in duration at both sites. Bipeaked waves were seen more frequently in patients than in normals at either 5 or 10 cm above the sphincter. Two patients, but none of the normal subjects, had triple-peaked waves. Lower esophageal sphincter pressure was significantly elevated in patients as compared to normals. Although percent relaxation of the sphincter was the same in patients and normals, the postrelaxation residual, or nadir, sphincter pressure was higher in patients. We conclude that patients with high-amplitude peristaltic contractions may also have abnormalities in duration of contractions, percent bipeaked waves, triple-peaked waves, or in parameters of the lower esophageal sphincter.
本研究旨在系统检查有症状的高振幅蠕动性食管收缩患者，即胡桃夹食管（n = 20），并与正常受试者（n = 30）进行比较的测压特征。在正常人和患者中，食管下括约肌上方5 cm处的收缩幅度和持续时间均比10 cm处更大。患者与正常人不仅在5 cm处的收缩幅度存在显著差异，在10 cm处以及两个位置的收缩持续时间上也有显著差异。在食管下括约肌上方5 cm或10 cm处，患者出现双峰波的频率比正常人更高。有两名患者出现了三峰波，而正常受试者均未出现。与正常人相比，患者的食管下括约肌压力显著升高。虽然患者和正常人的括约肌松弛百分比相同，但患者括约肌松弛后的残余压力或最低点压力更高。我们得出结论，高振幅蠕动性收缩患者在收缩持续时间、双峰波百分比、三峰波或食管下括约肌参数方面也可能存在异常。
