Kjellén G, Tibbling L
Scand J Gastroenterol. 1985 Oct;20(8):937-40. doi: 10.3109/00365528509088851.
Oesophageal motility was studied in 59 patients before and again after prolonged acid perfusion. In group 1 (n = 16), who were asymptomatic during the acid perfusion, no significant motility differences were obtained by perfusion. In group 2 (n = 18), who had heartburn, and in group 3 (n = 25), who had angina-like chest pain during acid perfusion, significant (p less than 0.01-0.001) changes of motility were seen: these included higher peristaltic amplitude, longer contraction duration, and slower peristaltic velocity. In addition, patients in group 3 showed a decrease (p less than 0.01) of peristaltic propagation and had secondary wave activity more often (p less than 0.01) during acid perfusion. Significantly (p less than 0.01) more patients in group 3 showed secondary wave activity after acid perfusion than in group 2. Pretest motility investigation did not separate the two acid-sensitive groups from the acid-unsensitive one, whereas the investigation of the lower oesophageal sphincter (LOS) did. Thus, LOS incompetence was significantly (p less than 0.01) commoner in the two symptomatic groups than in the asymptomatic group. We suggest that the motility changes observed during acid perfusion are secondary to increased sensory stimulation from the oesophagus but are not the cause of the symptoms. However, nervous reflex reactions from other chest organs, such as the heart, may also explain the results.
对59例患者在长时间酸灌注前后进行了食管动力研究。在第1组（n = 16）中，患者在酸灌注期间无症状，灌注后未发现明显的动力差异。在第2组（n = 18）中，患者有烧心症状，在第3组（n = 25）中，患者在酸灌注期间有心绞痛样胸痛，观察到明显（p < 0.01 - 0.001）的动力变化：包括蠕动幅度增加、收缩持续时间延长和蠕动速度减慢。此外，第3组患者在酸灌注期间蠕动传播减少（p < 0.01），继发性波活动更频繁（p < 0.01）。酸灌注后，第3组出现继发性波活动的患者明显多于第2组（p < 0.01）。预测试的动力研究未能将两个酸敏感组与酸不敏感组区分开来，而对食管下括约肌（LOS）的研究则做到了这一点。因此，两个有症状组中LOS功能不全的发生率明显高于无症状组（p < 0.01）。我们认为，酸灌注期间观察到的动力变化是食管感觉刺激增加的继发结果，但不是症状的原因。然而，来自其他胸部器官（如心脏）的神经反射反应也可能解释这些结果。
