Lock G, Pfeifer M, Straub R H, Zeuner M, Lang B, Schölmerich J, Holstege A
University of Regensburg, Department of Internal Medicine I, Germany.
Am J Gastroenterol. 1998 Mar;93(3):341-5. doi: 10.1111/j.1572-0241.1998.00341.x.
The aim of this study was to investigate the relationship between esophageal dysfunction and pulmonary involvement in patients with systemic sclerosis (SSc).
Pulmonary function parameters were compared between groups of patients with and without manometric evidence for SSc-induced esophageal dysmotility.
Twenty-six of 43 patients (60.5%) exhibited a marked hypo- or aperistalsis of the smooth muscle portion of the esophagus. Total lung capacity, inspiratory vital capacity, and forced vital capacity were significantly lower in patients with esophageal dysfunction compared with those with normal esophageal peristalsis (p < 0.001). Patients with the diffuse form of SSc (n = 20) had significantly lower values for total lung capacity and inspiratory vital capacity compared with patients with the limited type of SSc (n = 23; p < 0.05).
There is a significant association of esophageal dysmotility with reduced lung volumes in SSc. Possible explanations for these findings are pulmonary damage due to increased gastroesophageal reflux and, more likely, simultaneous involvement of the lungs and the esophagus in the disease process.
本研究旨在调查系统性硬化症(SSc)患者食管功能障碍与肺部受累之间的关系。
比较有和没有食管测压证据显示存在SSc诱发食管动力障碍的患者组之间的肺功能参数。
43例患者中有26例(60.5%)表现出食管平滑肌部分明显的蠕动减弱或无蠕动。与食管蠕动正常的患者相比,食管功能障碍患者的肺总量、吸气肺活量和用力肺活量显著降低(p<0.001)。弥漫型SSc患者(n=20)的肺总量和吸气肺活量值显著低于局限型SSc患者(n=23;p<0.05)。
SSc患者中食管动力障碍与肺容积减少显著相关。这些发现的可能解释是胃食管反流增加导致的肺部损伤,更有可能的是在疾病过程中肺部和食管同时受累。