Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
Division of Rheumatology Mayo Clinic Arizona, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
Rheumatol Int. 2021 Jul;41(7):1281-1287. doi: 10.1007/s00296-021-04806-6. Epub 2021 Feb 25.
Up to 90% of patients with systemic sclerosis (SSc) develop gastrointestinal (GI) symptoms. To evaluate whether GI symptoms and quality of life in patients with SSc demonstrate longitudinal stability. Consecutive patients with SSc (n = 100) completed the validated university of California at Los Angeles scleroderma clinical trial consortium gastrointestinal tract 2.0 (GIT) instrument and completed the same instrument approximately 5 years later. Comparison was made between patients with diffuse (dcSSc) and limited (lcSSc) subtypes and duration of disease of less than or greater than 5 years. GIT scores were calculated and analyzed for differences. 37 patients with dcSSc and 63 patients with lcSSc were included. Social functioning score significantly improved over time [0.44 (0.59)-0.31 (0.47); P = 0.003]. Total GIT scores were lower in patients with diffuse [0.51 (0.41)] compared with limited [(0.72 (0.53); P = 0.029] disease at both baseline and follow-up. Social functioning improved similarly in both dcSSc and lcSSc over time (P = 0.004). GIT Total scores increased in 27% (27/100) of patients and did not change or improved in 73% (73/100). Patients with worsening GI status had significantly increased scores on all GIT subscales. A lower body-mass index at baseline was significantly associated with worsening GIT Total score (OR 1.22; 95% CI 1.07-1.39; P < 0.001). Patients with SSc generally demonstrate longitudinal stability or improvement in their GI symptoms, but a subset of patients experience worsening of GI symptoms and negative impacts on GI-related quality of life.
多达 90%的系统性硬化症 (SSc) 患者出现胃肠道 (GI) 症状。评估 SSc 患者的 GI 症状和生活质量是否具有纵向稳定性。连续的 SSc 患者（n=100）完成了经过验证的加利福尼亚大学洛杉矶分校硬皮病临床试验联盟胃肠道 2.0 (GIT) 仪器，并在大约 5 年后完成了相同的仪器。比较弥漫性 (dcSSc) 和局限性 (lcSSc) 亚型以及疾病持续时间少于或超过 5 年的患者。计算 GIT 评分并分析差异。包括 37 例 dcSSc 患者和 63 例 lcSSc 患者。社会功能评分随时间显著改善[0.44（0.59）-0.31（0.47）；P=0.003]。弥漫性疾病患者的总 GIT 评分较低[0.51（0.41）]，而局限性疾病患者的总 GIT 评分较高[0.72（0.53）；P=0.029]，基线和随访时均如此。dcSSc 和 lcSSc 患者的社会功能随时间的推移改善情况相似（P=0.004）。27%（27/100）的患者的 GIT 总分增加，73%（73/100）的患者的 GIT 总分不变或改善。GI 状态恶化的患者在所有 GIT 子量表上的评分均显著升高。基线时较低的体重指数与 GIT 总分恶化显著相关（OR 1.22；95%CI 1.07-1.39；P<0.001）。SSc 患者的胃肠道症状通常表现出纵向稳定性或改善，但一部分患者的胃肠道症状恶化，胃肠道相关生活质量受到负面影响。
