Kahrilas P J, Dodds W J, Hogan W J, Kern M, Arndorfer R C, Reece A
Gastroenterology. 1986 Oct;91(4):897-904. doi: 10.1016/0016-5085(86)90692-x.
Esophageal exposure to acid is a major determinant in the pathogenesis of reflux esophagitis. In this study, we analyzed the esophageal peristaltic function of 177 patients and asymptomatic volunteers for abnormalities that could lead to prolonged esophageal acid clearance. The subjects were divided into five groups: normal volunteers, patient controls, patients with noninflammatory gastroesophageal reflux disease, patients with mild esophagitis, and ones with severe esophagitis. Manometric data were analyzed for the occurrence of failed primary peristalsis, for the occurrence of feeble peristalsis in the distal esophagus, and for hypotensive lower esophageal sphincter pressure. From an analysis of the data on control patients, peristaltic dysfunction was defined as the occurrence of either failed primary peristalsis or hypotensive peristalsis in the distal esophagus for over half of the test swallows. Peristaltic dysfunction was increasingly prevalent with increasing severity of peptic esophagitis, occurring in 25% of patients with mild esophagitis and 48% of patients with severe esophagitis. A correlation did not exist between the occurrence of peristaltic dysfunction and hypotensive lower esophageal sphincter pressure (less than or equal to 10 mmHg). We conclude that peristaltic dysfunction occurs in a substantial minority of patients with peptic esophagitis and could contribute to increased esophageal exposure to refluxed acid material.
食管暴露于酸性物质是反流性食管炎发病机制的主要决定因素。在本研究中，我们分析了177例患者和无症状志愿者的食管蠕动功能，以寻找可能导致食管酸清除时间延长的异常情况。受试者被分为五组：正常志愿者、患者对照组、非炎性胃食管反流病患者、轻度食管炎患者和重度食管炎患者。对测压数据进行分析，以确定原发性蠕动失败的发生率、食管远端蠕动减弱的发生率以及食管下括约肌压力降低的情况。通过对对照患者数据的分析，蠕动功能障碍被定义为超过一半的测试吞咽中出现原发性蠕动失败或食管远端蠕动减弱。随着消化性食管炎严重程度的增加，蠕动功能障碍越来越普遍，轻度食管炎患者中发生率为25%，重度食管炎患者中发生率为48%。蠕动功能障碍的发生与食管下括约肌压力降低（小于或等于10 mmHg）之间不存在相关性。我们得出结论，蠕动功能障碍在相当一部分消化性食管炎患者中出现，可能导致食管暴露于反流酸性物质的时间增加。
