Williams D, Thompson D G, Marples M, Heggie L, O'Hanrahan T, Bancewicz J
Department of Medicine, Hope Hospital, Salford.
Gut. 1994 Feb;35(2):165-71. doi: 10.1136/gut.35.2.165.
Relations between primary oesophageal peristaltic amplitude and traction force were studied in 30 normal volunteers, 12 patients with functional dysphagia, and 48 patients with gastro-oesophageal reflux disease, using a new intraluminal strain gauge device. Forces generated by swallowing in the normal oesophagus were 42 (35-60) g (median and interquartile range), a close positive correlation existing between traction force and contractile amplitude for each subject (r = 0.5 (0.38-0.6). Traction force increased with increasing balloon volume from 62 (50-73) g at 2 ml to 86 (70-105) g at 4 ml (p < 0.05), indicating distension related modulation of peristaltic force. Patients with oesophagitis generated lower traction forces on swallowing 30 (20-40) g compared with the normal subjects (p < 0.01), the degree of impairment being greatest in those patients with the most severe mucosal damage. Patients with gastro-oesophageal reflux without endoscopic oesophagitis also showed abnormal forces (32 22-38) g p < 0.01 v controls), which were similar to those patients with mild oesophagitis but were greater than those with severe oesophagitis (p < 0.05). In patients with functional dysphagia, forces were also impaired (28 (10-60) g p < 0.05 v controls) despite normal standard manometry. Our results show that measurement of the traction force generated by primary peristalsis provides information about oesophageal neuromuscular function that is not demonstrable by manometry alone and can be abnormal in patients with oesophageal symptoms in whom standard techniques are normal.
使用一种新型腔内应变仪装置，对30名正常志愿者、12名功能性吞咽困难患者和48名胃食管反流病患者的原发性食管蠕动幅度与牵引力之间的关系进行了研究。正常食管吞咽产生的力为42（35 - 60）克（中位数和四分位间距），每个受试者的牵引力与收缩幅度之间存在密切的正相关（r = 0.5（0.38 - 0.6））。随着气囊体积从2毫升时的62（50 - 73）克增加到4毫升时的86（70 - 105）克，牵引力增加（p < 0.05），表明蠕动力量存在与扩张相关的调节。食管炎患者吞咽时产生的牵引力较低，为30（20 - 40）克，与正常受试者相比（p < 0.01），在那些黏膜损伤最严重的患者中损害程度最大。无内镜下食管炎的胃食管反流患者也显示出异常的力（32（22 - 38）克，与对照组相比p < 0.01），与轻度食管炎患者相似，但大于重度食管炎患者（p < 0.05）。在功能性吞咽困难患者中，尽管标准测压正常，但力也受损（28（10 - 60）克，与对照组相比p < 0.05）。我们的结果表明，测量原发性蠕动产生的牵引力可提供有关食管神经肌肉功能的信息，这是单独测压无法显示的，并且在标准技术正常但有食管症状的患者中可能异常。
