Willing J, Davidson G P, Dent J, Cook I
Gastroenterology Unit, Adelaide Children's Hospital, South Australia.
Gut. 1993 Jul;34(7):904-10. doi: 10.1136/gut.34.7.904.
Motor events of the upper oesophageal sphincter associated with gastro-oesophageal reflux were evaluated in 53 symptomatic children (median age 13 months) who were studied recumbent and unsedated. Children were divided into four groups according to symptoms, and then into two groups according to the presence or absence of neurological deficit. No grouping had basal upper oesophageal sphincter pressure that differed significantly from any other. Oesophageal distention due to gastro-oesophageal reflux, which was recognisable as oesophageal common cavity episodes, was associated with augmentation of mean basal upper oesophageal sphincter pressure from 36.5 (SD 18) mm Hg to 48.5 (18) mm Hg (p < 0.0001), irrespective of whether gastro-oesophageal reflux caused oesophageal acidification. Abrupt relaxations of the upper oesophageal sphincter independent of swallowing and lasting up to three seconds occurred during 54% of common cavity episodes. Forty nine per cent of these relaxations occurred within four seconds after the onset of distention. The oesophageal distention caused by gastro-oesophageal reflux is a potent stimulus of transient upper oesophageal sphincter relaxations in children. These relaxations are a more likely explanation for oesophagopharyngeal reflux than defective basal upper oesophageal sphincter tone.
对53名有症状的儿童（中位年龄13个月）进行了评估，这些儿童在仰卧且未使用镇静剂的状态下，研究其与胃食管反流相关的食管上括约肌运动事件。根据症状将儿童分为四组，然后根据是否存在神经功能缺损分为两组。各分组的食管上括约肌基础压力与其他任何分组相比均无显著差异。胃食管反流导致的食管扩张，表现为食管共同腔事件，与食管上括约肌平均基础压力从36.5（标准差18）毫米汞柱增加到48.5（18）毫米汞柱相关（p<0.0001），无论胃食管反流是否导致食管酸化。在54%的共同腔事件中，出现了与吞咽无关且持续长达三秒的食管上括约肌突然松弛。其中49%的松弛发生在扩张开始后的四秒内。胃食管反流引起的食管扩张是儿童食管上括约肌短暂松弛的有力刺激因素。这些松弛比食管上括约肌基础张力缺陷更有可能是食管咽反流的原因。
