Veyrac M, Meunier L, Aubin J P, Guillot B, Michel B, Bories P, Meynadier J, Michel H
Presse Med. 1986 May 24;15(21):957-9.
Oesophageal motor function was studied by oesophageal manometry in 48 patients with progressive systemic sclerosis: 25 with proximal scleroderma and 23 with diffuse scleroderma. Oesophageal lesions were noted in 70% (74% in diffuse scleroderma; 64% in proximal scleroderma). Classical manometric signs of scleroderma were found in only 31% of patients. Peristaltic modifications might begin at the junction of the two muscular coats, since a four centimeter long aperistaltic suspended area was noted in that region in 20% of patients, especially in the proximal scleroderma group. Oesophageal motility and low lower oesophageal sphincter pressure account for the gastro-oesophageal reflux and may compromise respiratory function, as suggested by the high frequency of concurrent oesophageal and respiratory dysfunction in diffuse scleroderma. Systematic prevention of gastro-oesophageal reflux should perhaps be advocated as soon as abnormalities in oesophageal motility are diagnosed.
采用食管测压法对48例进行性系统性硬化症患者的食管运动功能进行了研究:25例为近端硬皮病患者,23例为弥漫性硬皮病患者。70%的患者存在食管病变(弥漫性硬皮病患者中为74%;近端硬皮病患者中为64%)。仅31%的患者发现了硬皮病的典型测压体征。蠕动改变可能始于两层肌层的交界处,因为20%的患者在该区域发现了4厘米长的无蠕动悬吊区,尤其是在近端硬皮病组。食管动力和较低的食管下括约肌压力导致胃食管反流,并可能损害呼吸功能,弥漫性硬皮病中食管和呼吸功能障碍并发的高频率情况表明了这一点。一旦诊断出食管动力异常,或许应提倡系统性预防胃食管反流。