系统性硬化症合并误吸患者的特征：一项单中心研究。
Characteristics of patients with systemic sclerosis with aspiration: A single-center study.
作者信息
Naganawa Tatsuaki, Hashimoto Takako, Ikeda Naomi, Takase Haruna, Dosoden Naoki, Ito Kodai, Sawada Marika, Ito Yumi, Watanabe Natsuko, Umeda Ai, Akamatsu Konomi, Kurumizawa Megumi, Nishino Jo, Fukaya Shusaku, Inamoto Yoko, Shibata Seiko, Otaka Yohei, Yasuoka Hidekata
机构信息
Division of Rheumatology, Department of Internal Medicine, School of Medicine, Fujita Health University, Aichi, Japan.
Faculty of Rehabilitation, School of Health Science, Fujita Health University, Aichi, Japan.
出版信息
J Scleroderma Relat Disord. 2025 Sep 11:23971983251370883. doi: 10.1177/23971983251370883.
OBJECTIVES
To investigate the prevalence of aspiration and its association with GI involvement and clinical features in systemic sclerosis (SSc).
METHODS
Fifty patients with SSc who underwent the videofluoroscopic (VF) swallowing study were included. Aspiration was identified by the presence of aspiration and/or penetration defined by the Penetration-Aspiration Scale. The radiological findings including the residue in the oral cavity, pharynx and esophagus, which reflect oral, pharyngeal, and esophageal involvement, were also evaluated.
RESULTS
Twenty-three patients (46%) had aspiration and/or penetration. Patients with aspiration and/or laryngeal penetration had more pharyngeal vallecular residue (None 22%, Trace 44%, Mild 56%; = 0.072) and esophageal residue (None 0%, Mild 20%, Moderate 40%, Severe 61%; = 0.010). Esophageal, pharyngeal, and lower GI involvement were found in 98%, 83%, and 54%, respectively. Notably, the group with esophageal and pharyngeal plus lower GI involvement had a higher frequency of aspiration and/or penetration (79% vs 28%; = 0.003), higher FSSG scores (18.4 ± 11.8 vs 5.4 ± 5.7; = 0.002), and higher UCLA GIT-2.0 total scores (None-to-Mild 47% vs 100%, Moderate 42% vs 0%, Severe-to-Very severe 11% vs 0%; = 0.001) compared to those limited esophageal and pharyngeal involvement. By multivariate analysis, aspiration and/or penetration was associated with pharyngeal vallecular residue (Odds ratio (OR) 3.71; = 0.012) and esophageal residue (OR 2.92; = 0.011), and higher UCLA GIT-2.0 scores for diarrhea (OR 3.68; = 0.028) and the total score (OR 4.21; = 0.046).
CONCLUSION
In our study, about half of the patients had aspiration and/or penetration in SSc. Aspiration was associated with the extent of radiographic abnormalities of pharyngeal and esophageal involvement on the VF swallowing study. Patients with lower GI have aspiration and high UCLA GIT-2.0 scores suggesting that these patients had more severe GI manifestation.
目的
探讨系统性硬化症（SSc）患者误吸的发生率及其与胃肠道受累情况和临床特征的关系。
方法
纳入50例接受视频荧光吞咽造影（VF）检查的SSc患者。根据渗透-误吸量表定义的误吸和/或渗透情况来确定误吸。还评估了包括口腔、咽部和食管残留情况的影像学表现，这些表现反映了口腔、咽部和食管的受累情况。
结果
23例患者（46%）存在误吸和/或渗透。存在误吸和/或喉部渗透的患者咽部梨状窝残留更多（无残留22%，微量残留44%，轻度残留56%；P = 0.072），食管残留也更多（无残留0%，轻度残留20%，中度残留40%，重度残留61%；P = 0.010）。食管、咽部和下胃肠道受累的发生率分别为98%、83%和54%。值得注意的是，食管、咽部加下胃肠道受累组的误吸和/或渗透发生率更高（79%对28%；P = 0.003），FSSG评分更高（18.4±11.8对5.4±5.7；P = 0.002），UCLA GIT - 2.0总分更高（无至轻度47%对100%，中度42%对0%，重度至极重度11%对0%；P = 0.001），与仅食管和咽部受累的患者相比。多因素分析显示，误吸和/或渗透与咽部梨状窝残留（比值比（OR）3.71；P = 0.012）、食管残留（OR 2.92；P = 0.011）以及UCLA GIT - 2.0腹泻评分更高（OR 3.68；P = 0.028）和总分更高（OR 4.21；P = 0.046）相关。
结论
在我们的研究中，约一半的SSc患者存在误吸和/或渗透。误吸与VF吞咽造影检查中咽部和食管受累的影像学异常程度相关。下胃肠道受累的患者存在误吸且UCLA GIT - 2.0评分较高，提示这些患者有更严重的胃肠道表现。
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