Richards W G, Sugarbaker D J
Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Chest Surg Clin N Am. 1995 Feb;5(1):157-71.
Esophageal peristalsis and sphincter function are controlled by the autonomic nervous system, with contributions from parasympathetic, sympathetic, and enteric divisions. Proximal regions, including the upper esophageal sphincter, are composed of striated muscle and are under direct (cholinergic) control of vagal motoneurons located in the nucleus ambiguus. Sequential peristaltic contraction is coordinated by a brainstem pattern generator circuit involving the nucleus of the solitary tract and modulated by vagal afferents. Distal esophageal regions including the lower sphincter are controlled by intramural enteric circuitry, with a poorly characterized contribution from vagal preganglionic fibers arising in the dorsal motor nucleus of the vagus. Peristaltic contraction depends on cholinergic (muscarinic) excitation and NO-mediated inhibition. Neurally-produced lower esophageal sphincter relaxation is mediated by NO, vasoactive intestinal polypeptide, or both.
食管蠕动和括约肌功能由自主神经系统控制，副交感神经、交感神经和肠神经系统均有参与。近端区域，包括食管上括约肌，由横纹肌组成，受位于疑核的迷走运动神经元的直接（胆碱能）控制。连续的蠕动收缩由一个涉及孤束核的脑干模式发生器回路协调，并受迷走传入神经调节。包括下括约肌在内的食管远端区域由壁内肠神经回路控制，来自迷走神经背运动核的迷走神经节前纤维的作用尚不明确。蠕动收缩依赖于胆碱能（毒蕈碱）兴奋和一氧化氮介导的抑制。神经产生的食管下括约肌松弛由一氧化氮、血管活性肠肽或两者介导。
