中国临床医学2017，Vol.24Issue(6)：892-899,8.DOI:10.12025/j.issn.1008-6358.2017.20170799
系统性硬化症累及上消化道的临床特征及影响因素分析
Clinical features and influencing factors of upper gastrointestinal tract involvement in systemic sclerosis
摘要
Abstract
Objective:To explore the clinical features of upper gastrointestinal tract involvement in systemic sclerosis (SSc),and analyze the influencing factors.Methods:Totally 52 hospitalized SSc patients in department of rheumatology of Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2011 to December 2015 were enrolled and divided into symptomatic group and asymptomatic group according to the gastrointestinal symptoms.All the cases underwent esophageal manometry,24 h esophageal pH monitoring,esophageal barium meal and (or) endoscopy.Meanwhile,data of esophageal manometry and 24 h esophageal pH monitoring of 18 outpatients with gastroesophageal reflux disease in the same period were collected.Results:In 52 SSc cases,there were 17 in asymptomatic group and 35 in symptomatic group.For skin changes,the incidences of finger skin sclerosis,finger tip damage and capillary dilation in symptomatic group were significantly higher than those in asymptomatic group (P＜0.05);the incidence of interstitial lung disease in symptomatic group was significantly higher than that in asymptomatic group (P＜0.05).There were no differences in levels of ANA,anticentromere antibody,anti Scl-70 antibody between two groups in SSc patients.For dynamic abnormalities,the UES relaxation rate was highest,and the LES pressure decay rate was the lowest in SSc patients.The Esophageal manometric parameters were not statistically different among three groups.The 24 h esophageal pH monitoring showed that DeMeester score in symptomatic group was significantly higher than that inasymptomatic group (P＜ 0.05).The positive rate of esophageal barium meal in symptomatic group was significantly higher than that in asymptomatic group (P ＜ 0.05),though the positive rate of gastroscopy was not statistically different.Conclusions:There are esophageal motility disorders and abnormal acid reflux in SSc patients with or without upper gastrointestinal symptoms,especially for those with upper gastrointestinal symptoms.For patients with long course of disease,finger skin sclerosis,finger tip damage,capillary dilation and interstitial lung disease,esophageal involvement should be alert.DeMeester score is helpful for early diagnosis.关键词
系统性硬化症/上消化道症状/食管动力/食管测压/24 h食管pH监测Key words
systemic sclerosis/upper gastrointestinal symptoms/esophageal motility/esophageal manometry/24 h esophageal pH monitoring分类
医药卫生引用本文复制引用
胥魏,袁风红,王磊,高恺言,邹耀红,张缪佳..系统性硬化症累及上消化道的临床特征及影响因素分析[J].中国临床医学,2017,24(6):892-899,8.基金项目
国家自然科学青年基金(81501345).Supported by National Natural Science Youth Foundation of China(81501345). （81501345）
