Liebermann-Meffert D, Klaus D, Vosmeer S, Allgöwer M
Scand J Gastroenterol Suppl. 1984;92:237-41.
We examined the effect of acid and bile on the lower esophageal high pressure zone (LEHPZ) in a combined manometric, pH testing and morphologic study in 12 cats. LEHPZ pressures and swallowing waves (SW) were simultaneously recorded before, during and after perfusion of the esophagus with control fluid, acid (0.1 n HCl) natural bile and a mixture of acid and bile. Endoscopy was performed and biopsies taken before and after the experiments. Bile caused a rise of LEHPZ and SW pressure and mild esophagitis. Acid and bile acid mixture produced a marked progressive decline of LEHPZ and SW pressure (p less than 0.001), incomplete relaxation and severe discoordination of esophageal motility. Continuous pH measurements showed diminished or no clearance and reflux. All acid perfused cats developed necrotic esophagitis and strictures within 4 weeks. LEHPZ pressures returned to almost normal values after this recovering period but peristalsis was still completely discoordinated. Swallowing waves were of exaggerated magnitude and length. From our findings it is evident that bile and acid change LEHPZ competence. Bile and acid seem to have a different effect on motor function of the LEHPZ and esophageal peristalsis.
我们在一项对12只猫进行的压力测定、pH值测试和形态学联合研究中，检测了酸和胆汁对食管下高压区（LEHPZ）的影响。在用对照液、酸（0.1N HCl）、天然胆汁以及酸与胆汁的混合物灌注食管之前、期间和之后，同时记录LEHPZ压力和吞咽波（SW）。在实验前后进行内镜检查并取活检。胆汁导致LEHPZ和SW压力升高以及轻度食管炎。酸与胆汁酸混合物使LEHPZ和SW压力显著逐渐下降（p小于0.001），食管运动出现不完全松弛和严重失调。连续pH测量显示清除或反流减少或无清除和反流。所有灌注酸的猫在4周内出现坏死性食管炎和狭窄。在此恢复阶段后，LEHPZ压力恢复到几乎正常的值，但蠕动仍完全失调。吞咽波的幅度和长度增大。从我们的研究结果明显看出，胆汁和酸改变了LEHPZ的功能。胆汁和酸似乎对LEHPZ的运动功能和食管蠕动有不同的影响。
