结缔组织疾病食管运动功能研究

The Study of Esophageal Motility in Rheumatic Disease

目的 :对结缔组织疾病患者进行食管运动功能研究 ,并对部分患者治疗前后的结果进行比较 ,以研究结缔组织疾病食管运动功能障碍的特点及其对治疗的反应。方法 :结缔组织疾病患者 2 9例 (类风湿性关节炎 7例 ,SLE 8例 ,硬皮病 7例 ,皮肌炎 2例 ,SLE合并硬皮病 2例 ,SLE合并皮肌炎 3例 )。其中食管症状组 15例 ,非食管症状组 14例。10例有食管症状的患者在确诊后进行激素或 /和免疫抑制剂的治疗 (疗程 3月 ) ,治疗后 3月再次重复食管测压。并与健康对照组 2 9例进行各项指标的比较。结果 :( 1)结缔组织疾病患者食管测压结果 :病例组远端食管蠕动压 (PA)、传导时间 (PD)、传导速度 (PV)与健康组相比有显著性差异 (P <0 0 5 ,P <0 0 1)。 ( 2 )食管症状组下食管括约肌压力 (LESP)、松弛率 (LESR)、PA、PD、PV与健康组和非食管症状组相比有显著性差异 (P <0 0 5 ,P <0 0 1)。 ( 3 )治疗后LESP、LESR、PA提高 ,以PA改变尤为明显。 ( 4 )治疗前后食管异常收缩波的百分比 :治疗前同步收缩的百分比为 2 1 4% ,治疗后为 1 1% (P <0 0 0 1)。结论 :本组结缔组织疾病出现食管运动功能障碍 ,有食管症状组较非食管症状组食管受累更为明显 ,治疗后随病情好转食管运动功能障碍得到改善。

Purpose: To investigate the esophageal motility in rheumatic disease. Methods: Rheumatic patients (n=29) and healthy subjects (n=29) entered the study. Esophageal manometry was performed in subjects and all patients before and after treatment (Prednisolone or immunosuppressant). Results: (1) In rheumatic group, PA, PD, and PV were significantly abnormal than those in control group (P<0.05,P<0.01). (2) There were significantly difference between esophageal symptom group and healthy subjects in LESP?LESR?PA?PD?PV. (3)After treatment, LESP?LESR and PA were improved, especially PA. (4)The percentage of abnormal peristalsis was 21.4% before treatment and 1.1% after treatment (P< 0.001 ). Conclusion: The were esophageal motility disorder in rheumatic disease, especially esophageal symptom group. After treatment, the abnormal were improved.