Pulmonary Division, Heart Institute (InCor), University of São Paulo, Brazil.
Respir Med. 2009 Jun;103(6):854-60. doi: 10.1016/j.rmed.2008.12.018. Epub 2009 Feb 6.
Mixed connective tissue disease is a systemic inflammatory disorder that results in both pulmonary and esophageal manifestations.
We sought to evaluate the relationship between esophageal dysfunction and interstitial lung disease in patients with mixed connective tissue disease.
We correlated the pulmonary function data and the high-resolution computed tomography findings of interstitial lung disease with the results of esophageal evaluation in manometry, 24-hour intraesophageal pH measurements, and the presence of esophageal dilatation on computed tomography scan.
Fifty consecutive patients with mixed connective tissue disease, according to Kasukawa's classification criteria, were included in this prospective study. High-resolution computed tomography parenchymal abnormalities were present in 39 of 50 patients. Esophageal dilatation, gastroesophageal reflux, and esophageal motor impairment were also very prevalent (28 of 50, 18 of 36, and 30 of 36, respectively). The presence of interstitial lung disease on computed tomography was significantly higher among patients with esophageal dilatation (92% vs. 45%; p<0.01) and among patients with severe motor dysfunction (90% vs. 35%; p<0.001).
Although we were not able to prove a causal relationship between esophageal and pulmonary involvement, our series revealed a strong association between esophageal motor dysfunction and interstitial lung disease in patients with mixed connective tissue disease.
混合性结缔组织病是一种系统性炎症性疾病，可同时导致肺部和食管表现。
我们旨在评估混合性结缔组织病患者的食管功能障碍与间质性肺病之间的关系。
我们将肺功能数据以及高分辨率计算机断层扫描（HRCT）间质性肺病的发现与食管测压、24 小时食管内 pH 测量和 CT 扫描显示的食管扩张结果相关联。
50 例连续的符合 Kasukawa 分类标准的混合性结缔组织病患者被纳入这项前瞻性研究。39 例患者 HRCT 存在肺实质异常。食管扩张、胃食管反流和食管运动障碍也非常普遍（28/50、18/36 和 30/36）。CT 显示存在间质性肺病的患者中食管扩张的发生率显著更高（92%比 45%；p<0.01），且严重运动功能障碍的发生率也显著更高（90%比 35%；p<0.001）。
尽管我们未能证明食管和肺部受累之间存在因果关系，但我们的系列研究显示在混合性结缔组织病患者中，食管运动功能障碍与间质性肺病之间存在强烈关联。
