系统性硬化症患者食管动力与临床特征的研究  

Study on esophageal motility and clinical characteristics in patients with systemic sclerosis

作　　者：施赛男 鲍云 王美峰[1] 林琳[1] 姜柳琴[1] SHI Sainan;BAO Yun;WANG Meifeng;LIN Lin;JIANG Liuqin(Department of Gastroenterology,The First Affiliated Hospital With Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院消化内科,南京210029

出　　处：《医学研究与战创伤救治》2024年第1期58-62,共5页Journal of Medical Research & Combat Trauma Care

摘　　要：目的探讨系统性硬化症(SSc)患者累及食管功能的临床特征及影响因素。方法回顾性分析2016年1月至2022年12月南京医科大学第一附属医院胃肠动力中心接受HREM检查的SSc患者的临床资料。分析其食管动力特征、临床特征与食管动力的相关性。结果29例SSc患者中存在食管症状者18例,吞咽困难为最常见症状(44.8%)。食管体部动力障碍最多见,尤其是失蠕动及蠕动异常。反酸与食管体部无效蠕动百分比(APR)呈正相关(r s=0.497,P<0.05)。消化道外受累系统数量与平均远端收缩积分(DCI)呈负相关,与APR呈正相关(r s=-0.466、0.408,P<0.05)。血沉与上食管括约肌残余压及DCI呈负相关(P<0.05),补体C3、C4含量与APR呈负相关(P<0.05)。结论SSc患者易出现食管动力异常,伴有食管症状,且食管功能障碍可发生在无食管症状时。SSc累及系统越多、病情越重、疾病活动更易伴有食管功能异常。Objective To explore the clinical characteristics and influencing factors of esophageal function in patients with systemic sclerosis(SSc).Methods The clinical data of SSc patients who underwent high-resolution esophageal manometry(HREM)examination at the Gastrointestinal Motility Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2022 were retrospectively analyzed.The correlation between its esophageal motility characteristics,clinical characteristics,and esophageal motility were analyzed.Results Among 29 patients with SSc,18 patients had esophageal symptoms,and dysphagia was the most common symptom(13/29,44.8%).Esophageal body motility disorders were the most common,especially aperistalsis and abnormal peristalsis.Acid reflux was positively correlated with absent peristalsis rate(APR)of esophageal body(r s=0.497,P<0.05).The number of involved systems outside the digestive tract was negatively correlated with the average distal contraction integral(DCI),while positively correlated with APR(r s=-0.466 and 0.408,both P<0.05).Erythrocyte sedimentation rate was negatively correlated with upper esophageal sphincter residual pressure and DCI(P<0.05).Serum C3 and C4 levels were negatively correlated with APR(P<0.05).Conclusion Patients with SSc are prone to abnormal esophageal motility and esophageal symptoms,and esophageal dysfunction can occur in the absence of esophageal symptoms.The more systems SSc involves,the more severe the condition,and disease activity is more likely to be accompanied by esophageal dysfunction.

关 键 词：系统性硬化症 食管症状 食管动力 高分辨率食管测压 系统累及 

分 类 号：R593.25[医药卫生—内科学]