Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan.
Ann Nucl Med. 2009 Nov;23(9):771-6. doi: 10.1007/s12149-009-0310-0. Epub 2009 Oct 24.
Esophageal complications are common in patients with systemic sclerosis (SSc). The relationship between gastroesophageal reflux (GER) symptoms and dysmotility was examined in endoscopically confirmed patients suspected of having reflux esophagitis.
A total of 32 patients with limited and diffuse type SSc (lSSc, dSSc) were examined based on a structured questionnaire score (QS) of GER symptoms, retention fraction of esophageal scintigraphy at 90 s (R(90)) and gastric emptying time.
The QS was significantly higher in the reflux esophagitis group than in the non-esophagitis group (5.4 +/- 3.5, 1.4 +/- 2.9, P = 0.003). When the non-esophagitis group was further divided into lSSc and dSSc groups, R(90) was higher in the reflux esophagitis group (31 +/- 18%) and the non-esophagitis group with dSSc (34 +/- 32%) than in the non-esophagitis group with lSSc (8 +/- 3%, P = 0.02). Both high R(90) >or= 15% and QS >or= 4 indicated reflux esophagitis. Conversely, both normal R(90) and QS indicated no reflux esophagitis.
A combination of esophageal scintigraphy and structured questionnaire demonstrated different aspects of esophageal dysfunction, namely dysmotility and GER. Patients with high QS and dysmotility may be indicated for further evaluation including endoscopic examination and medical treatment.
系统性硬化症（SSc）患者常发生食管并发症。本研究旨在检查内镜证实的反流性食管炎可疑患者中胃食管反流（GER）症状与动力障碍之间的关系。
根据 GER 症状的结构问卷评分（QS）、食管闪烁扫描 90 秒时的滞留分数（R（90））和胃排空时间，对 32 例局限性和弥漫性 SSc（lSSc、dSSc）患者进行检查。
反流性食管炎组的 QS 明显高于非食管炎组（5.4+/-3.5、1.4+/-2.9，P=0.003）。进一步将非食管炎组分为 lSSc 和 dSSc 两组，反流性食管炎组和 dSSc 非食管炎组的 R（90）均高于 lSSc 非食管炎组（31+/-18%和 34+/-32%，P=0.02）。高 R（90）>或=15%和 QS>或=4 均提示反流性食管炎。相反，正常的 R（90）和 QS 提示无反流性食管炎。
食管闪烁扫描和结构问卷的联合检查显示了食管功能障碍的不同方面，即动力障碍和 GER。高 QS 和动力障碍的患者可能需要进一步评估，包括内镜检查和药物治疗。
