类风湿关节炎合并真菌性食管炎临床研究

Clinical research of rheumatoid arthritis with esophagitis

目的探讨类风湿关节炎（RA）并发真菌性食管炎的内镜及临床特征,有利于及时调整治疗方案。方法选取经胃镜检查诊断为真菌性食管炎的患者66例,对比分析RA合并真菌性食管炎患者31例与单纯真菌性食管炎35例患者的内镜及临床资料,采用χ~2检验进行统计分析。结果 RA并发真菌性食管炎无消化道症状者占71.0%（22/31）,非RA组为5.7%（2/35）;RA组Ⅲ-Ⅳ级真菌性食管炎发病率58.1%（18/31）,非RA组为28.5%（10/35）;RA组应用免疫抑制剂、糖皮质激素药物治疗病例为100%（31/31）,非RA组为5.7%（2/35）,两组差异具有统计学意义（P〈0.05）。结论RA患者合并真菌性食管炎多无消化道症状,对于长期大量使用糖皮质激素、免疫抑制剂或抑酸剂的高危RA患者应及时行胃镜检查从而保证RA并发真菌性食管炎的患者可得到及时诊治。

Objective To explore the endoscopic and clinical characteristics of rheumatoid arthritis（ RA） patients with fungal esophagitis for early treatment adjustment.Methods We selected 66 patients diagnosed fungal esophagitis（ 31 combined with RA） in Xi ＇ an Fifth Hospital.We compared 31 fungal esophagitis patients combined with RA with 35 noncomplicated fungal esophagitis patients.All data was analyzed by chi- square test.Results There were 71.0%（ 22 /31） of patients in RA group showed no significant gastrointestinal symptoms while 5.7%（ 2 /35） of patients in the noncomplicated fungal esophagitis group showed no significant gastrointestinal symptoms（ P〈 0.05）;the incidence of Ⅲ ~ Ⅳ fungal esophagitis in RA group and noncomplicated fungal esophagitis group was 58.1%（ 18 /31） and 28.5%（ 10 /35） separately（ P〈 0.05）;There were 100%（ 31 /31） of patients in RA group were under the treatment of glucocorticoid and immunosuppressants while 5.7%（ 2 /35） of patients in noncomplicated fungal esophagitis group were under the treatment of glucocorticoid and immunosuppressants（ P〈 0.05）.Conclusion There is no significant gastrointestinal symptoms in patients with RA combined with fungal esophagitis.Gastroscopy is necessary for high-risk RA patients with long-term use of glucocorticoid and immunosuppressants or acid suppression.