Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.
Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Arthritis Res Ther. 2019 Feb 12;21(1):52. doi: 10.1186/s13075-019-1840-z.
Systemic sclerosis (SSc) has been suggested to cause exocrine pancreatic dysfunction. However, a case-control-based autopsy study failed to associate systemic sclerosis with any pancreatic histopathology. The primary objective of this study was to examine the exocrine pancreatic function in consecutive SSc patients in relation to an age- and sex-matched control group. A secondary objective was to relate exocrine pancreatic function to radiological, laboratory, and clinical SSc characteristics.
One hundred twelve consecutive patients fulfilling the 2013 American Congress of Rheumatology/European League Against Rheumatism criteria for SSc and 52 control subjects were matched for sex and age. Exocrine pancreatic function was assessed by ELISA-based measurement of fecal elastase, and levels ≤ 200 μg/g were considered pathological, i.e., representing exocrine pancreatic insufficiency. Patients were characterized regarding SSc manifestations including gastrointestinal and hepatobiliary function, by use of laboratory and clinical examinations. Pancreas parenchyma characteristics were evaluated by high-resolution computer tomography (HRCT).
A similar proportion of subjects exhibited pathological levels of fecal elastase among SSc patients (6/112; 5.4%) and control subjects (3/52; 5.8%). Patients with fecal elastase ≤ 200 μg/g did not differ from other SSc patients with respect to laboratory and clinical characteristics, including malnutrition. SSc subjects with low levels of fecal elastase displayed significantly lower pancreas attenuation on HRCT examinations compared to the control subjects.
In this study encompassing 112 consecutive SSc patients and 52 matched control subjects, we were unable to associate systemic sclerosis with clinically significant exocrine pancreatic dysfunction.
系统性硬化症（SSc）被认为会导致外分泌胰腺功能障碍。然而，一项基于病例对照的尸检研究未能将系统性硬化症与任何胰腺组织病理学联系起来。本研究的主要目的是检查连续 SSc 患者的外分泌胰腺功能与年龄和性别匹配的对照组。次要目的是将外分泌胰腺功能与放射学、实验室和临床 SSc 特征联系起来。
112 例符合 2013 年美国风湿病学会/欧洲抗风湿病联盟 SSc 标准的连续 SSc 患者和 52 例对照者按性别和年龄匹配。通过 ELISA 法测定粪便弹性蛋白酶来评估外分泌胰腺功能，将 ≤200μg/g 的水平视为病理水平，即代表外分泌胰腺功能不全。通过实验室和临床检查，对 SSc 表现（包括胃肠道和肝胆功能）对患者进行特征描述。通过高分辨率计算机断层扫描（HRCT）评估胰腺实质特征。
SSc 患者（6/112；5.4%）和对照组（3/52；5.8%）中出现粪便弹性蛋白酶病理水平的比例相似。粪便弹性蛋白酶 ≤200μg/g 的患者与其他 SSc 患者在实验室和临床特征方面没有差异，包括营养不良。粪便弹性蛋白酶水平较低的 SSc 患者在 HRCT 检查中胰腺衰减明显低于对照组。
在这项包括 112 例连续 SSc 患者和 52 例匹配对照者的研究中，我们未能将系统性硬化症与临床上明显的外分泌胰腺功能障碍联系起来。
