硬皮病消化系统受累临床表现及诊治进展

Clinical manifestations and treatment progress of gastrointestinal involvement in scleroderma

约90%的硬皮病患者可出现不同程度的消化系统受累,其发病机制可能与胶原蛋白沉积、自身抗体作用、平滑肌细胞炎症及萎缩、特征性纤维化等有关。消化系统受累的常见临床表现多样,主要包括胃食管反流病、Barrett食管、胃轻瘫、假性肠梗阻、小肠细菌过度生长、便秘等。早期诊断和治疗对改善预后尤为关键。因此,本文就硬皮病消化系统受累临床诊治的最新进展作一综述,以期提高其诊治水平。

It was estimated that approximately 90% of patients with scleroderma had different degree of gastrointestinal tract involvement .The pathophysiology could relate to collagen deposition ,autoantibodies ,smooth muscle cell inflammation and atrophy , and the characteristic fibrosis . Major manifestations include gastroesophageal reflux disease （GERD） ,Barrett esophagus ,gastroparesis ,intestinal pseudo‐obstruction ,small intestinal bacterial overgrowth （SIBO） ,and constipation .Early diagnosis and treatment were crucial to improve prognosis .This article reviewed the latest progress in manifestations ,diagnosis and treatment of gastrointestinal involvement in scleroderma ,thus to improve the clinical diagnosis and treatment .