Abstract：
BACKGROUND: Chagas disease causes digestive anatomic and functional changes, including the loss of the myenteric plexus and abnormal esophageal radiologic and manometric findings.
OBJECTIVE: To evaluate the association of abnormal esophageal radiologic findings, cardiac changes, distal esophageal contractions, and complaints of dysphagia and constipation in upper (UES) and lower (LES) esophageal sphincter basal pressure in Chagas disease patients.
METHODS: The study evaluated 99 patients with Chagas disease and 40 asymptomatic normal volunteers. The patients had normal esophageal radiologic examination (n=61) or esophageal retention without an increase in esophageal diameter (n=38). UES and LES pressure was measured with the rapid pull-through method in a 4-channel water-perfused round catheter. Before manometry, the patients were asked about dysphagia and constipation and submitted to electrocardiography and chest radiography.
RESULTS: The amplitude of esophageal distal contraction decreased from controls to chagasic patients with esophageal retention. The proportion of failed and simultaneous contractions increased in patients with abnormal radiologic examination (P<0.01). There were no significant differences in UES and LES pressure between the groups. UES pressure was similar between Chagas disease patients with cardiomegaly (n=27, 126.5±62.7 mmHg) and those without it (n=72, 144.2±51.6 mmHg, P=0.26). Patients with constipation had lower LES pressure (n=23, 34.7±20.3 mmHg) than those without it (n=76, 42.9±20.5 mmHg, P<0.03).
CONCLUSIONS: Chagas disease patients with absent or mild esophageal radiologic involvement had no significant changes in UES and LES basal pressure. Constipation complaints are associated with decreased LES basal pressure.
OBJECTIVE: To evaluate the association of abnormal esophageal radiologic findings, cardiac changes, distal esophageal contractions, and complaints of dysphagia and constipation in upper (UES) and lower (LES) esophageal sphincter basal pressure in Chagas disease patients.
METHODS: The study evaluated 99 patients with Chagas disease and 40 asymptomatic normal volunteers. The patients had normal esophageal radiologic examination (n=61) or esophageal retention without an increase in esophageal diameter (n=38). UES and LES pressure was measured with the rapid pull-through method in a 4-channel water-perfused round catheter. Before manometry, the patients were asked about dysphagia and constipation and submitted to electrocardiography and chest radiography.
RESULTS: The amplitude of esophageal distal contraction decreased from controls to chagasic patients with esophageal retention. The proportion of failed and simultaneous contractions increased in patients with abnormal radiologic examination (P<0.01). There were no significant differences in UES and LES pressure between the groups. UES pressure was similar between Chagas disease patients with cardiomegaly (n=27, 126.5±62.7 mmHg) and those without it (n=72, 144.2±51.6 mmHg, P=0.26). Patients with constipation had lower LES pressure (n=23, 34.7±20.3 mmHg) than those without it (n=76, 42.9±20.5 mmHg, P<0.03).
CONCLUSIONS: Chagas disease patients with absent or mild esophageal radiologic involvement had no significant changes in UES and LES basal pressure. Constipation complaints are associated with decreased LES basal pressure.
摘要：
背景：查加斯病会引起消化道解剖和功能改变，包括肌间神经丛的丢失和食管放射和测压异常。
目的：评估异常食管影像学表现的相关性，心脏变化,远端食管收缩,Chagas病患者的上（UES）和下（LES）食管括约肌基础压力的吞咽困难和便秘。
方法：该研究评估了99例Chagas病患者和40例无症状正常志愿者。患者的食管放射学检查正常（n=61）或食管保留而食管直径没有增加（n=38）。在4通道水灌注的圆形导管中，使用快速拉穿方法测量UES和LES压力。在测压之前，患者被询问吞咽困难和便秘，并接受心电图和胸片检查。
结果：食管远端收缩幅度从对照组下降到有食管保留的chagasic患者。放射学检查异常的患者收缩失败和同时收缩的比例增加（P<0.01）。两组之间的UES和LES压力没有显着差异。有心脏肥大的查加斯病患者（n=27，126.5±62.7mmHg）和没有心脏肥大的患者（n=72，144.2±51.6mmHg，P=0.26）。便秘患者的LES压力（n=23，34.7±20.3mmHg）低于无便秘患者（n=76，42.9±20.5mmHg，P<0.03)。
结论：Chagas病患者无或轻度食管影像学受累，UES和LES基础压无明显变化。便秘主诉与LES基础压力降低有关。
目的：评估异常食管影像学表现的相关性，心脏变化,远端食管收缩,Chagas病患者的上（UES）和下（LES）食管括约肌基础压力的吞咽困难和便秘。
方法：该研究评估了99例Chagas病患者和40例无症状正常志愿者。患者的食管放射学检查正常（n=61）或食管保留而食管直径没有增加（n=38）。在4通道水灌注的圆形导管中，使用快速拉穿方法测量UES和LES压力。在测压之前，患者被询问吞咽困难和便秘，并接受心电图和胸片检查。
结果：食管远端收缩幅度从对照组下降到有食管保留的chagasic患者。放射学检查异常的患者收缩失败和同时收缩的比例增加（P<0.01）。两组之间的UES和LES压力没有显着差异。有心脏肥大的查加斯病患者（n=27，126.5±62.7mmHg）和没有心脏肥大的患者（n=72，144.2±51.6mmHg，P=0.26）。便秘患者的LES压力（n=23，34.7±20.3mmHg）低于无便秘患者（n=76，42.9±20.5mmHg，P<0.03)。
结论：Chagas病患者无或轻度食管影像学受累，UES和LES基础压无明显变化。便秘主诉与LES基础压力降低有关。
