Enzmann D R, Harell G S, Zboralske F F
Gastroenterology. 1977 Jun;72(6):1292-8.
This investigation determined the site(s) of elicitation and origin of secondary peristalsis in the human esophagus and characterized the upper esophageal sphincter (UES) and proximal esophageal body responses accompanying intraluminal distention. In 7 normal persons, an intraluminal transducer probe manometrically recorded the UES and 5- and 10-cm levels of the esophageal body. A second probe with a balloon attached 2 cm above the proximal strain gauge was located so that the balloon was 3 and 4 cm below the UES and 4 distentions were done. The balloon probe was moved in 2-cm increments (four distensions at each site) until lower esophageal sphincter pressures were recorded. No secondary peristalsis occurred after distention in the proximal 6 cm. The incidence of secondary peristalsis increased as the distention site moved distally. Sixty-nine per cent of secondary peristaltic waves orignated in the esophageal body proximal to the distention site. The UES pressure significantly increased over resting pressure (augmentation) during 63% of distentions. The esophagus proximal to the balloon and below the UES usually responded to distention with augmentation. Augmentation of the UES and proximal esophageal body in response to esophageal intraluminal distention and the resultant initiation of secondary peristalsis above the distention site comprise a highly integrated pressure barrier to esophagopharyngeal reflex.
本研究确定了人类食管继发性蠕动的引发部位和起源，并描述了腔内扩张时食管上括约肌（UES）和食管近端主体的反应。在7名正常人中，腔内换能器探头通过测压记录UES以及食管主体5厘米和10厘米水平处的情况。在近端应变仪上方2厘米处连接一个带气囊的第二个探头，使其气囊位于UES下方3厘米和4厘米处，并进行4次扩张。气囊探头以2厘米的增量移动（每个部位进行4次扩张），直到记录到食管下括约肌压力。在近端6厘米处扩张后未出现继发性蠕动。继发性蠕动的发生率随着扩张部位向远端移动而增加。69%的继发性蠕动波起源于扩张部位近端的食管主体。在63%的扩张过程中，UES压力显著高于静息压力（增强）。气囊上方和UES下方的食管通常对扩张产生增强反应。UES和食管近端主体对食管腔内扩张的增强反应以及由此在扩张部位上方引发的继发性蠕动，构成了对食管咽反射的高度整合的压力屏障。
