de Oliveira R B, Rezende Filho J, Dantas R O, Iazigi N
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil.
Am J Gastroenterol. 1995 Jul;90(7):1119-24.
To determine the patterns of esophageal motility found in patients with Chagas' disease.
Clinical, manometric, and scintigraphic data were obtained from 43 subjects with positive serological tests for Chagas' disease and nondilated esophagus and 10 patients with Chagasic megaesophagus.
Twenty (46.5%) of the seropositive subjects with nondilated esophagus were asymptomatic, and 23 (53.5%) had dysphagia, but only 12 (27.9%) had persistent dysphagia, a feature typical of Chagasic megaesophagus; only two (4.6%) had chest pain. Manometric findings within the seropositive group were: normal motility in 16 subjects, peristaltic multipeaked contractions in three, aperistalsis of the esophagus with relaxing lower esophageal sphincter in nine, and aperistalsis with nonrelaxing lower esophageal sphincter in 15 subjects. All of 10 megaesophagus patients had aperistalsis of the esophagus plus nonrelaxing lower esophageal sphincter. Scintigraphy was as sensitive as manometry in detecting esophageal dysmotility, but the erect scintigraphy was abnormal in subjects with complete aperistalsis only.
In Chagas' disease, megaesophagus appears to be a disorder at the most severe end of a spectrum encompassing classical achalasia and its milder variants. Other esophageal motility disorders are rare, but normal esophageal function is common.
确定恰加斯病患者的食管动力模式。
从43例恰加斯病血清学检测呈阳性且食管未扩张的受试者以及10例恰加斯病巨食管患者中获取临床、测压和闪烁扫描数据。
43例血清学阳性且食管未扩张的受试者中，20例（46.5%）无症状，23例（53.5%）有吞咽困难，但只有12例（27.9%）有持续性吞咽困难，这是恰加斯病巨食管的典型特征；只有2例（4.6%）有胸痛。血清学阳性组的测压结果为：16例受试者食管动力正常，3例有多峰蠕动收缩，9例食管无蠕动且食管下括约肌松弛，15例食管无蠕动且食管下括约肌不松弛。10例巨食管患者均有食管无蠕动且食管下括约肌不松弛。闪烁扫描在检测食管动力障碍方面与测压一样敏感，但仅在完全无蠕动的受试者中直立位闪烁扫描异常。
在恰加斯病中，巨食管似乎是一种最严重的疾病，涵盖经典贲门失弛缓症及其较轻的变体。其他食管动力障碍罕见，但食管功能正常很常见。
