Santos Inês, Marques-Gomes Carlos, Diz-Lopes Mariana, Terroso Georgina, Costa Lúcia, Miriam Ferreira Raquel
Rheumatology Unit, Hospital de São Teotónio, Unidade Local de Saúde Viseu Dão-Lafões, Viseu, Portugal.
Rheumatology Department, Unidade Local de Saúde de São João, Porto, Portugal.
J Scleroderma Relat Disord. 2025 Aug 8:23971983251362586. doi: 10.1177/23971983251362586.
The relationship between manometric changes and esophageal dilation on chest high-resolution computed tomography is well established in systemic sclerosis, but its association with extra-esophageal manifestations is inconsistent. This study aims to characterize manometric findings in systemic sclerosis patients and to determine potential associations with esophageal body dysmotility.
Retrospective single-center study including adult systemic sclerosis patients who underwent conventional or high-resolution esophageal manometry. Demographic and clinical data were collected. Associations between esophageal motility and disease duration, immunologic profile, cutaneous and pulmonary involvement, as well as endoscopic or tomographic esophageal alterations were evaluated.
A total of 76 patients were included. Conventional manometry was performed in 60 (78.9%), with aperistalsis observed in 23 (38.3%) and a normotonic lower esophageal sphincter in 45 (75.0%). Sixteen patients (21.1%) underwent high-resolution esophageal manometry, showing normal motility in 9 (56.3%), normotonic lower esophageal sphincter in 9 (56.3%), and hypotonic lower esophageal sphincter in 7 (43.8%). Overall, 46 patients (60.5%) had esophageal body dysmotility and 54 (71.1%) had normotonic lower esophageal sphincter. Most patients (84.2%) had limited cutaneous disease. Median disease duration was 5 years (interquartile range = 11) with mean age 54.1 ± 12.4 years. Seventy-one patients (93.4%) were females. Potential associations with manometric esophageal involvement were compared between patients with normal motility and dysmotility. Esophageal dilation on chest high-resolution computed tomography was more frequent among those with dysmotility (p = 0.005). No significant differences were found regarding disease duration, immunologic profile, modified Rodnan skin score, esophagitis, Barrett's esophagus, interstitial lung disease, forced vital capacity, or single-breath carbon monoxide diffusing capacity.
Esophageal involvement was frequent in our sample, although the lower esophageal sphincter was more commonly spared. An association between esophageal dysmotility and its dilation on chest high-resolution computed tomography was found, highlighting the utility of chest high-resolution computed tomography for identification of upper gastrointestinal involvement in systemic sclerosis. No association was found between manometric changes and extra-esophageal manifestations.
在系统性硬化症中，食管测压变化与胸部高分辨率计算机断层扫描显示的食管扩张之间的关系已得到充分证实，但其与食管外表现的关联并不一致。本研究旨在描述系统性硬化症患者的测压结果，并确定与食管体运动障碍的潜在关联。
一项回顾性单中心研究，纳入接受传统或高分辨率食管测压的成年系统性硬化症患者。收集人口统计学和临床数据。评估食管运动与疾病持续时间、免疫谱、皮肤和肺部受累情况以及内镜或断层扫描显示的食管改变之间的关联。
共纳入76例患者。60例（78.9%）进行了传统测压，其中23例（38.3%）观察到无蠕动，45例（75.0%）食管下括约肌压力正常。16例（21.1%）进行了高分辨率食管测压，其中9例（56.3%）运动正常，9例（56.3%）食管下括约肌压力正常，7例（43.8%）食管下括约肌压力降低。总体而言，46例（60.5%）患者存在食管体运动障碍，54例（71.1%）食管下括约肌压力正常。大多数患者（84.2%）患有局限性皮肤疾病。疾病中位持续时间为5年（四分位间距 = 11），平均年龄为54.1±12.4岁。71例（93.4%）为女性。比较了运动正常和运动障碍患者与测压食管受累的潜在关联。胸部高分辨率计算机断层扫描显示食管扩张在运动障碍患者中更常见（p = 0.005）。在疾病持续时间、免疫谱、改良Rodnan皮肤评分、食管炎、巴雷特食管、间质性肺病、用力肺活量或单次呼吸一氧化碳弥散量方面未发现显著差异。
在我们的样本中，食管受累很常见，尽管食管下括约肌更常未受累。发现食管运动障碍与其在胸部高分辨率计算机断层扫描上的扩张之间存在关联，突出了胸部高分辨率计算机断层扫描在识别系统性硬化症上消化道受累方面的实用性。未发现测压变化与食管外表现之间存在关联。
