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28 例系统性硬化症巴西患者的食管测压:结果与相关性。

Esophageal manometry in 28 systemic sclerosis Brazilian patients: findings and correlations.

机构信息

Rheumatology Division of the Department of Musculoskeletal System, Clinics Hospital, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

出版信息

Dis Esophagus. 2009;22(8):700-4. doi: 10.1111/j.1442-2050.2009.01000.x. Epub 2009 Jul 31.

Abstract

Systemic sclerosis (SSc) is a multisystem disease of unknown etiology. Esophageal involvement affects 50-90% of patients and is characterized by abnormal motility and hypotonic lower esophageal sphincter. Data on the association of esophageal abnormalities and age, gender, SSc subset or duration, autoantibody profile, esophageal symptoms, and medication are lacking or conflicting. The aim of this study was the evaluation of these associations in Brazilian sclerodermic patients from the Rheumatology Division, Clinics Hospital, Federal University, Minas Gerais. They underwent medical records review, clinical interview, and esophageal manometry. The normal cutoff level for lower esophageal sphincter pressure was 14 mmHg. Abnormal peristalsis occurred when less than 80% of peristaltic waves were propagated. P-values less than 0.05 were considered significant. Twenty-eight patients were included: 71% were women. The population presented medium age and disease duration of 46 years and 12 years, respectively. Cutaneous diffuse SSc occurred in 39% and its limited form in 61%. Dysphagia, pyrosis, and regurgitation occurred, respectively, in 71%, 43%, and 61% of patients. Lower esophageal sphincter pressure and number of peristaltic waves-propagated medias were, respectively, 17.2 mmHg and 2.3. SSc-related manometric abnormalities were present in 86% of patients. Manometry revealed distal esophageal body hypomotility, hypotonic lower esophageal sphincter, or both, respectively, in 82%, 39%, and 36% of patients. One patient presented the manometric pattern of esophageal achalasia. Male patients more frequently presented hypotonic inferior esophageal sphincter. Manometric findings have had no relationship with the other variables. Nifedipine use did not influence manometric findings.

摘要

系统性硬化症(SSc)是一种病因不明的多系统疾病。食管受累影响 50-90%的患者,其特征为运动异常和低张性下食管括约肌。关于食管异常与年龄、性别、SSc 亚型或病程、自身抗体谱、食管症状和药物之间的关系的数据缺乏或相互矛盾。本研究的目的是评估巴西风湿病学系硬皮病患者的这些相关性,该患者来自米纳斯吉拉斯联邦大学临床医院。他们接受了病历回顾、临床访谈和食管测压。下食管括约肌压力的正常截断值为 14mmHg。当少于 80%的蠕动波传播时,发生异常蠕动。P 值小于 0.05 被认为有统计学意义。共纳入 28 例患者:71%为女性。该人群的平均年龄和病程分别为 46 岁和 12 年。弥漫性皮肤 SSc 占 39%,局限性皮肤 SSc 占 61%。分别有 71%、43%和 61%的患者出现吞咽困难、烧心和反流。下食管括约肌压力和传播的蠕动波中位数分别为 17.2mmHg 和 2.3。86%的患者存在与 SSc 相关的测压异常。测压分别显示 82%、39%和 36%的患者远端食管体低动力、低张性下食管括约肌或两者均有。1 例患者出现食管失弛缓症的测压模式。男性患者更常出现低张性下食管括约肌。测压结果与其他变量无关。硝苯地平的使用并不影响测压结果。

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