Iovino P, Valentini G, Ciacci C, De Luca A, Tremolaterra F, Sabbatini F, Tirri E, Mazzacca G
Department of Medical and Surgery of Digestive Disease, Medical School, Federico 11 University, Naples Italy.
Dig Dis Sci. 2001 Apr;46(4):723-30. doi: 10.1023/a:1010779729184.
Gastrointestinal involvement is frequent in patients with systemic sclerosis (SSc); however, studies on the proximal stomach and its regulation are lacking. It has been hypothesized that the primary event in the pathogenesis of gastrointestinal involvement in SSc is an early neural lesion. This study investigates proximal stomach function and its relation to autonomic nerve function in SSc. Twenty SSc patients classified in to clinical subsets, underwent measurement of proximal stomach function with and without glucagon by electronic barostat and an assessment of autonomic nerve function. SSc patients were not significantly different from 11 controls for gastric compliance (59.5+/-5.0 vs 47.7+/-4.2 ml/mm Hg, P = 0.1). The pressure-volume curves in each participant with and without glucagon were significantly different (P < 0.001). A significant positive association was found between gastric compliance and autonomic nerve function (P < 0.05). The change in gastric compliance during glucagon administration was significant-associated with autonomic function (P < 0.05). The perception cumulative scores did not differ between SSc patients and control subjects (P = 0.2). In conclusion, proximal stomach function is associated with autonomic nerve function in SSc patients. This confirms the frequent association of motility disorders with autonomic dysfunction in SSc.
胃肠道受累在系统性硬化症(SSc)患者中很常见;然而,关于近端胃及其调节的研究却很缺乏。有人推测,SSc胃肠道受累发病机制中的主要事件是早期神经病变。本研究调查了SSc患者近端胃的功能及其与自主神经功能的关系。20例分为临床亚组的SSc患者,通过电子恒压器测量了有无胰高血糖素时的近端胃功能,并评估了自主神经功能。SSc患者与11名对照者在胃顺应性方面无显著差异(59.5±5.0 vs 47.7±4.2 ml/mm Hg,P = 0.1)。每个参与者在有和没有胰高血糖素时的压力-容积曲线有显著差异(P < 0.001)。胃顺应性与自主神经功能之间存在显著正相关(P < 0.05)。给予胰高血糖素期间胃顺应性的变化与自主神经功能显著相关(P < 0.05)。SSc患者与对照者之间的感知累积评分无差异(P = 0.2)。总之,SSc患者近端胃功能与自主神经功能相关。这证实了SSc中运动障碍与自主神经功能障碍之间经常存在关联。