Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP, Brasil.
Arq Gastroenterol. 2024 Jun 17;61:e23174. doi: 10.1590/S0004-2803.24612023-174. eCollection 2024.
Chagas disease causes digestive anatomic and functional changes, including the loss of the myenteric plexus and abnormal esophageal radiologic and manometric findings.
To evaluate the association of abnormal esophageal radiologic findings, cardiac changes, distal esophageal contractions, and complaints of dysphagia and constipation in upper (UES) and lower (LES) esophageal sphincter basal pressure in Chagas disease patients.
The study evaluated 99 patients with Chagas disease and 40 asymptomatic normal volunteers. The patients had normal esophageal radiologic examination (n=61) or esophageal retention without an increase in esophageal diameter (n=38). UES and LES pressure was measured with the rapid pull-through method in a 4-channel water-perfused round catheter. Before manometry, the patients were asked about dysphagia and constipation and submitted to electrocardiography and chest radiography.
The amplitude of esophageal distal contraction decreased from controls to chagasic patients with esophageal retention. The proportion of failed and simultaneous contractions increased in patients with abnormal radiologic examination (P<0.01). There were no significant differences in UES and LES pressure between the groups. UES pressure was similar between Chagas disease patients with cardiomegaly (n=27, 126.5±62.7 mmHg) and those without it (n=72, 144.2±51.6 mmHg, P=0.26). Patients with constipation had lower LES pressure (n=23, 34.7±20.3 mmHg) than those without it (n=76, 42.9±20.5 mmHg, P<0.03).
Chagas disease patients with absent or mild esophageal radiologic involvement had no significant changes in UES and LES basal pressure. Constipation complaints are associated with decreased LES basal pressure.
恰加斯病可引起消化解剖和功能改变，包括肠神经丛丧失和食管异常放射学及测压表现。
评估恰加斯病患者食管异常放射学表现、心脏改变、食管远段收缩、吞咽困难和/或便秘症状与上（UES）和下（LES）食管括约肌基础压的相关性。
研究纳入 99 例恰加斯病患者和 40 名无症状正常志愿者。患者行食管正常放射学检查（n=61）或食管潴留但无食管直径增加（n=38）。UES 和 LES 压力采用 4 通道水灌注圆形导管快速牵拉法测量。测压前，患者报告吞咽困难和便秘情况，并接受心电图和胸部 X 线检查。
食管远段收缩幅度从对照组到伴有食管潴留的恰加斯病患者逐渐降低。异常放射学检查患者的失败收缩和同时收缩比例增加（P<0.01）。各组间 UES 和 LES 压力无显著差异。伴有或不伴有心脏扩大的恰加斯病患者的 UES 压力相似（n=27，126.5±62.7mmHg 和 n=72，144.2±51.6mmHg，P=0.26）。伴有便秘的患者的 LES 压力较低（n=23，34.7±20.3mmHg），而不伴有便秘的患者的 LES 压力较高（n=76，42.9±20.5mmHg，P<0.03）。
食管放射学表现缺失或轻微的恰加斯病患者的 UES 和 LES 基础压无明显变化。便秘症状与 LES 基础压降低有关。
